Publications and Forms
Health Care Provider's Response to Request for Award on Undisputed Facts in Regard to Application for Direct Payment (WC-202)
A health care provider’s response to a request for an award on undisputed facts in regard to an application for direct payment medical fee dispute.
Questions and Affidavit Regarding Completeness of Medical Information Submitted - Affidavit Form E (WCT-6)
Questions and affidavit for claimant regarding completeness of medical information submitted, form E.