PDF
Word
CC- Form 17 Physician Disclosure Statement - Oklahoma
What Is CC- Form 17?
This is a legal form that was released by the Oklahoma Workers Compensation Commission - a government authority operating within Oklahoma. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is CC- Form 17?
A: CC- Form 17 is a Physician Disclosure Statement in Oklahoma.
Q: What is the purpose of CC- Form 17?
A: CC- Form 17 is used to disclose any financial interest or relationship that a physician may have with a healthcare facility.
Q: Who needs to fill out CC- Form 17?
A: Physicians in Oklahoma who have financial interests or relationships with healthcare facilities need to fill out CC- Form 17.
Q: What should be included in CC- Form 17?
A: CC- Form 17 should include details of any financial interest or relationship with a healthcare facility, such as ownership, investment, compensation, or partnership.
Q: Is CC- Form 17 mandatory for all physicians?
A: Yes, all physicians in Oklahoma with financial interests or relationships with healthcare facilities are required to fill out CC- Form 17.
Form Details:
- Released on February 2, 2016;
- The latest edition provided by the Oklahoma Workers Compensation Commission;
- 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 CC- Form 17 by clicking the link below or browse more documents and templates provided by the Oklahoma Workers Compensation Commission.
