Report of Suspected Medical Care Provider Fraud Forms
| Form Name | Report of Suspected Medical Care Provider Fraud |
| Form # | DWC Form SMBFR 1115 |
| Form Revision | (Rev. 3/2006) |
| Category | Forms » Legal/Fraud |
| Downloads | |
| Form State | California |
| Language | English |
| State Description | n/a |
| Claimwire Description | n/a |