Louisiana Forms
4 State Forms found
| name | number | revision | print or send online | |
|---|---|---|---|---|
Physician Choice Form: NOTICE TO INJURED WORKERS |
Form LWC – WC 1121 | No Form/Rev Date | ||
DISPUTED CLAIM FOR MEDICAL TREATMENT |
LWC-WC 1009 | Rev 12/2014 | ||
REQUEST FOR INDEPENDENT MEDICAL EXAMINATION |
LWC-WC 1015 | REVISED 10/14 | ||
WORKERS’ COMPENSATION RECORDS REQUEST FORM |
LWC-WC-1150 | Revised 12/05/23 | ||
Disclaimer: These forms may not be the most recent version. Louisiana may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on this site. Please check official sources.
Loading results ...