5873
This form is used for claiming dependent's benefits in the event of a fatality in Arizona.
This form is used for medical treatment preauthorization in Arizona.
This Form is used for notifying the carrier about a scheduled injury in the state of Arizona.
This document is used by carriers to be notified of a scheduled injury in Arizona.
This type of document is used to inform the carrier about a scheduled injury in Arizona.
This form is used for reporting earned paid sick time in Arizona.
This form is used for employers to respond to inquiries regarding workers' compensation insurance in Arizona.
This document is used for filing a supplemental claim for compensation for workers in the state of Arizona. It allows workers to request additional compensation for work-related injuries or illnesses.
This form is used for filing a minimum wage claim in Arizona. It is intended for labor disputes related to wages and ensures that employees receive the legally mandated minimum wage.
This form is used for carriers in Arizona to refer individuals for vocational rehabilitation services.
This Form is used for filing a Petition for Attorney's Fees in Arizona under a.r.s. 23-1069.
This Form is used for reporting a worker's injury in Arizona. It requires information from both the worker and the physician involved.
This Form is used for filing a supplemental claim for workers in Arizona. It provides additional documentation for workers' compensation claims.
This form is used for the apportionment settlement letter in Arizona for SpecFunds ICA5527.
This form is used for filing a claim to recover unpaid wages in the state of Arizona.
This Form is used for adding, changing, or deleting health and nutrition services entity data in the state of Arizona.
This document provides instructions for feeding infants in the state of Arizona. It covers topics such as breastfeeding, formula feeding, and introduction of solid foods.
This document is used for emergency preparedness and contains important information and immunization records for residents of Arizona.
This type of document is an agreement specific to computer software in the state of Arizona. It outlines the terms and conditions for the use of software and protects the rights of both parties involved.
This document is used for submitting a claim to the Center Sponsor in Arizona for reimbursement or compensation.
This document is used for filing a claim for a center site in Arizona. It helps in organizing and documenting the necessary information for the claim process.
This form is used for reporting the cost of food service in Arizona. It helps to track and analyze expenses related to food service operations.
This document is used for tracking the number of meals served at a Point of Service (POS) in Arizona, including breakfast, lunch, and snacks.
This document is used for recording the number of breakfast, lunch, and snack meals served at Point of Service in Arizona. It helps track and monitor the meal count for meal programs.
This type of document is used for determining the level of a supplier in Arizona.
This form is used for reconciliation purposes in the state of Arizona. It allows individuals or businesses to provide a detailed account of financial transactions over a five-day period.
This document is used for recording the number of meals and snacks served during a meal program and weekend care in Arizona.
This form is used for requesting a change to the calendar in Arizona.
This form is used for parents in Arizona to indicate their preference for infant feeding.
This type of document provides instructions on completing the application process for obtaining a liquor license in Arizona.
This Form is used for applying for growler privileges with a Series 12 liquor license in Arizona.