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This document provides instructions for employees of Cal Poly State University to pre-designate their primary care physician for treatment in the event of a work-related injury or illness. It includes
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How to fill out instructions for predesignation of
How to fill out INSTRUCTIONS FOR PREDESIGNATION OF PERSONAL PHYSICIAN
01
Obtain the 'Instructions for Predesignating a Personal Physician' form from your employer or the relevant workers' compensation office.
02
Read the instructions carefully to understand the requirements and the information needed.
03
Fill in your personal information such as your name, contact details, and any other required identification.
04
Select a physician from the provided list or write in your chosen personal physician's details, ensuring they meet the qualifications.
05
Sign and date the form to acknowledge your understanding of the predesignation process.
06
Submit the completed form to your employer's HR department or designated personnel.
07
Keep a copy of the form for your records.
Who needs INSTRUCTIONS FOR PREDESIGNATION OF PERSONAL PHYSICIAN?
01
Employees who wish to predesignate a personal physician for workers' compensation purposes.
02
Individuals who have a preexisting relationship with a physician and want to ensure they can see them for work-related injuries.
03
Workers looking to streamline their medical care process in the event of a workplace injury.
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What is INSTRUCTIONS FOR PREDESIGNATION OF PERSONAL PHYSICIAN?
INSTRUCTIONS FOR PREDESIGNATION OF PERSONAL PHYSICIAN is a document that allows employees to choose a specific doctor to handle their medical care in the event of a work-related injury or illness.
Who is required to file INSTRUCTIONS FOR PREDESIGNATION OF PERSONAL PHYSICIAN?
Employees who wish to predesignate their personal physician for work-related injuries or illnesses are required to file the INSTRUCTIONS FOR PREDESIGNATION OF PERSONAL PHYSICIAN.
How to fill out INSTRUCTIONS FOR PREDESIGNATION OF PERSONAL PHYSICIAN?
To fill out the INSTRUCTIONS FOR PREDESIGNATION OF PERSONAL PHYSICIAN, employees need to provide their personal information, the name and contact details of the chosen physician, and sign the document to validate the predesignation.
What is the purpose of INSTRUCTIONS FOR PREDESIGNATION OF PERSONAL PHYSICIAN?
The purpose of the INSTRUCTIONS FOR PREDESIGNATION OF PERSONAL PHYSICIAN is to ensure that employees have the right to select their personal physician for medical treatment related to work-related injuries or illnesses, thus facilitating a smoother claims process.
What information must be reported on INSTRUCTIONS FOR PREDESIGNATION OF PERSONAL PHYSICIAN?
The information that must be reported includes the employee's name, contact information, the name and address of the personal physician, and the signature of the employee to confirm the selection.
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