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DWC Form 9768.5 Physician Contract Application (Independent Medical Reviewer) - California
What Is DWC Form 9768.5?
This is a legal form that was released by the California Department of Industrial Relations - Division of Workers' Compensation - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is DWC Form 9768.5?
A: DWC Form 9768.5 is the Physician Contract Application (Independent Medical Reviewer) form used in California.
Q: Who uses DWC Form 9768.5?
A: Physicians who wish to become Independent Medical Reviewers in California use DWC Form 9768.5.
Q: What is the purpose of DWC Form 9768.5?
A: The purpose of DWC Form 9768.5 is to apply for a contract as an Independent Medical Reviewer in California.
Form Details:
- Released on May 1, 2007;
- The latest edition provided by the California Department of Industrial Relations - Division of Workers' Compensation;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of DWC Form 9768.5 by clicking the link below or browse more documents and templates provided by the California Department of Industrial Relations - Division of Workers' Compensation.
Download DWC Form 9768.5 Physician Contract Application (Independent Medical Reviewer) - California
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