This version of the form is not currently in use and is provided for reference only. Download this version of Form F245-417-000 for the current year.
This is a legal form that was released by the Washington State Department of Labor and Industries - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is F245-417-000?
A: F245-417-000 is a form used for requesting Physical/Occupational/Massage Therapy Provider Hotline Service Authorization in Washington.
Q: Who can use this form?
A: This form can be used by Physical/Occupational/Massage Therapy Providers in Washington.
Q: What is the purpose of the form?
A: The form is used to request authorization for Hotline Service from the provider.
Q: Is this form specific to Washington?
A: Yes, this form is intended for use in Washington.
Q: Is there a fee for submitting this form?
A: No, there is no fee associated with submitting this form.
Q: What is the hotline service?
A: The hotline service is a service provided by Physical/Occupational/Massage Therapy Providers to offer telephonic support and guidance to injured workers.
Q: Is authorization required for providing the hotline service?
A: Yes, authorization is required before the provider can start offering the hotline service.
Q: Who should I contact for more information about this form?
A: For more information about this form, you can contact the Washington State Department of Labor & Industries.
Form Details:
Download a fillable version of Form F245-417-000 by clicking the link below or browse more documents and templates provided by the Washington State Department of Labor and Industries.