PDF
Word
Form HP-4 Notice to Chair: Health Provider's and Insurer's Withdrawal of Request for Arbitration - New York
What Is Form HP-4?
This is a legal form that was released by the New York State Workers' Compensation Board - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form HP-4?
A: Form HP-4 is a notice used to inform the Chair of the New York State Workers' Compensation Board about the withdrawal of a request for arbitration by a health provider and insurer.
Q: Who uses Form HP-4?
A: Health providers and insurers in New York use Form HP-4 to withdraw their request for arbitration in workers' compensation cases.
Q: What is the purpose of Form HP-4?
A: The purpose of Form HP-4 is to officially notify the Chair of the Workers' Compensation Board about the withdrawal of a request for arbitration in a workers' compensation case.
Q: Is Form HP-4 specific to New York?
A: Yes, Form HP-4 is specific to the state of New York.
Q: Are there any fees associated with submitting Form HP-4?
A: No, there are no fees associated with submitting Form HP-4.
Form Details:
- Released on April 1, 2005;
- The latest edition provided by the New York State Workers' Compensation Board;
- 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 Form HP-4 by clicking the link below or browse more documents and templates provided by the New York State Workers' Compensation Board.
Download Form HP-4 Notice to Chair: Health Provider's and Insurer's Withdrawal of Request for Arbitration - New York
1
2
