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Toll Free: 1-800-276-7619, Ext. 4264 Assuring Address: http://assurelink.assurity.com Washington Application for Acci-Flex Insurance This application includes all forms needed to apply for Acci-Flex
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How to fill out washington application for acci-flex

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How to fill out the Washington application for Acci-Flex:

01
Go to the website of the Washington Department of Labor and Industries.
02
Look for the Acci-Flex option under the Forms and Publications section.
03
Download the application form for Acci-Flex.
04
Fill out the necessary information in the form, such as your name, address, and contact details.
05
Provide your employment details, including your employer's name and contact information.
06
Answer the questions regarding your job duties and physical requirements.
07
Indicate whether you have any pre-existing conditions that may affect your ability to perform certain tasks.
08
Sign and date the application form.
09
Submit the completed application to the appropriate department or agency as instructed.

Who needs the Washington application for Acci-Flex?

01
Individuals who are employed in industries where physical labor or manual tasks are involved may need the Washington application for Acci-Flex.
02
Workers who wish to apply for coverage under the Acci-Flex program provided by the Washington Department of Labor and Industries would also require this application.
03
Employers who want to ensure their employees' safety and provide them with the necessary benefits in case of work-related injuries or accidents may need to facilitate the completion of this application.
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Washington application for acci-flex is a form used to apply for the Accident Fund benefit program in the state of Washington.
Employees who have been injured on the job and are seeking benefits from the Accident Fund program in Washington are required to file the application.
To fill out the Washington application for acci-flex, individuals must provide information about their injury, employment history, medical treatment, and other relevant details.
The purpose of the Washington application for acci-flex is to allow individuals to apply for benefits from the Accident Fund program in cases of work-related injuries.
Information that must be reported on the Washington application for acci-flex includes details about the injury, medical treatment received, employment history, and other relevant information.
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