Legal Forms >> New York >> Workers' Compensation
Form #:NY-WC-C-4 This form is used by a doctor who has, for the first time, treated an employee who was injured on the job. The form will be sent to the Workers' Compensation Board, the insurance carrier, and either the employee or the employee's physician. The doctor should provide specific details about the injury, the initial examination, the patient's history and work information, and the recommended treatment. Work status information is also included.
Name:Doctor's Initial Report Form Number: NY-WC-C-4 State:New York Statute: Form Category:Workers' Compensation
This form is only available as a downloadable PDF which will be made available to you after you complete your purchase.
Search MillerDavis.com for legal forms and specialty products.
All of our forms include standard shipping at no additional cost.