Forms/Laws
  • Home /
  • Texas Forms

Texas Forms

Change State
Select Report Type  
 

 247 State Forms found

name number revision print or send online

Workers' Compensation Health Care Network Management Contract Checklist

 LHL722 0622

Complaint Form - ONLINE ONLY

 CP012 Rev. 06/2018

Request to get reimbursed for travel costs (Spanish)

 DWC048S Rev. 07/21

Workers' Compensation Complaint Form

 DWC154 Rev. 03/16

Workers' Compensation Complaint Form (Spanish)

 DWC154S Rev. 03/16

Notice of Denial of Compensability/Liability and Refusal to Pay Benefits - EDI

 PLN-1 Rev. 07/21

NOTICE OF REPRESENTATION (Spanish)

 DWC150S (Rev. 12/16)

NOTICE OF WITHDRAWAL OF REPRESENTATION

 DWC150a (Rev. 11/17)

Notice of Denial of Compensability/Liability and Refusal to Pay Benefits (Spanish) - EDI

 PLN-1S 07/21

Notice of Maximum Medical Improvement and No Permanent Impairment - EDI

 PLN-3a Rev. 07/21

Notice of Maximum Medical Improvement and No Permanent Impairment (Spanish) - EDI

 PLN-3aS 07/21

Notice of Maximum Medical Improvement and Permanent Impairment - EDI

 PLN-3b Rev. 07/21

Notice of Maximum Medical Improvement and Permanent Impairment (Spanish) - EDI

 PLN-3bS Rev. 07/21

Notice of Maximum Medical Improvement and Estimated Permanent Impairment - EDI

 PLN-3c Rev. 07/21

Notice of Maximum Medical Improvement and Estimated Permanent Impairment (Spanish) - EDI

 PLN-3cS Rev. 07/21
Disclaimer: These forms may not be the most recent version. Texas 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 ...
Origami Risk
1379 N 1075 W, Suite 226,
Farmington, UT 84025
312.546.6515
info@origamirisk.com
© 2025 Origami Risk. All Rights Reserved.