Georgia Forms
10 State Forms found
| name | number | revision | print or send online | |
|---|---|---|---|---|
MEDICAL REPORT |
WC-20a | REVISION 12/2018 | ||
AUTHORIZATION AND CONSENT TO RELEASE MEDICAL INFORMATION |
WC-207 | REVISION 7/2024 | ||
CONSOLIDATED YEARLY REPORT OF MEDICAL ONLY CASES AND ANNUAL PAYMENTS ON INDEMNITY CLAIMS |
WC-26 | REVISION 7/2023 | ||
REQUEST FOR AUTHORIZATION OF TREATMENT OR TESTING BY AUTHORIZED MEDICAL PROVIDER |
WC-205 | REVISION 7/2021 | ||
REQUEST / OBJECTION FOR CHANGE OF PHYSICIAN / ADDITIONAL TREATMENT |
WC-200b | REVISION 7/2021 | ||
MANAGED CARE ORGANIZATION PROCEDURES OFFICIAL NOTICE |
WC-P3 | (7/2022) | ||
MANAGED CARE ORGANIZATION PROCEDURES OFFICIAL NOTICE (Spanish) |
WC-P3 | (8/2023) | ||
CHANGE OF PHYSICIAN / ADDITIONAL TREATMENT BY CONSENT |
WC-200a | REVISION 7/2021 | ||
PETITION FOR MEDICAL TREATMENT |
WC-PMT | REVISION 07/2023 | ||
PETITION FOR MEDICAL TREATMENT (b)/FAILURE TO ATTEND MEDICAL APPOINTMENT WITH AN AUTHORIZED TREATING PHYSICIAN |
WC-PMT(b) | REVISION 7/2024 | ||
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