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