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 136 State Forms found

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EMPLOYMENT HISTORY FORM

 F242-109-000 1-06

Work Status Form

 F242-052-000 09-2021

Address Change Request for Injured Workers

 F242-388-000 07-2011

Address Change Request for Injured Workers (Spanish)

 F242-388-999 07-2011

Address Change Request for Pensioners

 F242-107-000 07-2011

Transfer of Care (Spanish)

 F245-037-999 01-2018

Department of Labor and Industries Home Modification Acknowledgement of Responsibilities

 F247-003-000 08-2020

EMPLOYMENT HISTORY FORM (Spanish)

 F242-109-999 1-06

Inquiry for Assessment of Damages

 F242-067-000 10-2015

Interpretive Services Appointment Record

 F245-056-000 10-2020

Request for Claim Information

 F242-430-000 06-2017

SELF-INSURED EMPLOYER'S PERMANENT PARTIAL DISABILITY CLOSURE ORDER AND NOTICE - PPD-TL (Spanish)

 F207-164-999 08-2013

Submission of Provider Credentials for Interpretive Services

 F245-055-000 06-2020

Workers' Compensation Filing Information

 F207-155-000 12-2022

Application to Reopen Claim due to Worsening of Condition

 F242-079-000 08-2019
Disclaimer: These forms may not be the most recent version. Washington 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.
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