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Form F252-091-000 Chronic Opioid Request Form - Washington
What Is Form F252-091-000?
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.
FAQ
Q: What is Form F252-091-000?
A: Form F252-091-000 is the Chronic Opioid Request Form in Washington.
Q: What is the purpose of Form F252-091-000?
A: The purpose of Form F252-091-000 is to request authorization for chronic opioid use in Washington.
Q: Who needs to use Form F252-091-000?
A: Patients in Washington who require chronic opioid use need to use Form F252-091-000.
Q: What information is required on Form F252-091-000?
A: Form F252-091-000 requires information about the patient, prescriber, opioid medication, and the medical condition requiring chronic opioid use.
Q: What happens after submitting Form F252-091-000?
A: After submitting Form F252-091-000, the request will be reviewed by the Washington State Department of Labor & Industries for authorization of chronic opioid use.
Q: Is there a fee associated with Form F252-091-000?
A: No, there is no fee associated with submitting Form F252-091-000.
Form Details:
- Released on January 1, 2015;
- The latest edition provided by the Washington State Department of Labor and Industries;
- 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 F252-091-000 by clicking the link below or browse more documents and templates provided by the Washington State Department of Labor and Industries.
Download Form F252-091-000 Chronic Opioid Request Form - Washington
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