Post Accident Drug Screen Flu Shot DOT Physical Lift Test Authorization Form BAT Providence Risk eScreen Passport Hair Testing First Report of Injury Basic Physical WC Recheck Audiogram Non- Subscriber Corporate Remedies Adjuster to Schedule EPS Mechanism of Injury Referred Provider to Schedule Impairment Rating WC New Nurse Case Manager Physical Therapy Referral Chest X-Ray Subscriber Quantiferon Gold OSHA OccMed Work Queue DWC73 Spirometry/PFT TB Skin Test DWC69 Post Accident Drug Screen Flu Shot DOT Physical Lift Test Authorization Form BAT Providence Risk eScreen Passport Hair Testing First Report of Injury Basic Physical WC Recheck Audiogram Non- Subscriber Corporate Remedies Adjuster to Schedule EPS Mechanism of Injury Referred Provider to Schedule Impairment Rating WC New Nurse Case Manager Physical Therapy Referral Chest X-Ray Subscriber Quantiferon Gold OSHA OccMed Work Queue DWC73 Spirometry/PFT TB Skin Test DWC69
(Print)
Post Accident Drug Screen
Flu Shot
DOT Physical
Lift Test
Authorization Form
BAT
Providence Risk
eScreen Passport
Hair Testing
First Report of Injury
Basic Physical
WC Recheck
Audiogram
Non-Subscriber
Corporate Remedies
Adjuster to Schedule
EPS
Mechanism of Injury
Referred Provider to Schedule
Impairment Rating
WC New
Nurse Case Manager
Physical Therapy Referral
Chest X-Ray
Subscriber
Quantiferon Gold
OSHA
OccMed Work Queue
DWC73
Spirometry/PFT
TB Skin Test
DWC69
