Fillable c060 online form

Description
When your doctor or chiropractor sends in your medical report we will confirm your injury. September 2014 P. O. BOX 2415 EDMONTON AB T5J 2S5 WORKER REPORT Phone 780-498-3999 in Edmonton 1-800-661-9608 outside Alberta Fax of Injury or Occupational Disease Seven Digit Claim 780-427-5863 or 1-800-661-1993 Past the date of injury Have you been off work Yes No Last Name First Name Mailing Address Apt C060 Initial...
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