Notice and Proposal and Application for a Division Independent Medical Examination Forms
| Form Name | Notice and Proposal and Application for a Division Independent Medical Examination |
| Form # | WC77 |
| Form Revision | Rev 04/25 |
| Category | Forms » Medical/Health |
| Downloads | |
| Form State | Colorado |
| Language | English |
| State Description | After filing a Notice and Proposal (Form WC146), this application is used by a claimant or insurer to request and Independent Medical Examination (IME) through the Division... |
| Claimwire Description | n/a |