Physician's Report of Worker's Compensation Injury Forms
| Form Name | Physician's Report of Worker's Compensation Injury |
| Form # | WC164 |
| Form Revision | Rev 02/19 |
| Category | Forms » First Report |
| Downloads | |
| Form State | Colorado |
| Language | English |
| State Description | This form is used by the physician to provide information on the status, progress and medical treatment of the injured worker. |
| Claimwire Description | n/a |