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EMPLOYEES REDESIGNATION OF PERSONAL PHYSICIAN TO: UCI Human Resources Workers Compensation Unit 1000 Berkeley Place Irvine, CA 926974600 FROM: Employee Name (please print) EMPLOYEE ID# SOCIAL SECURITY#
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Start by downloading the pre-designat1doc - hr uci form from the appropriate source or website. It is usually available in PDF format.
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Begin by filling out your personal information section, which may include your full name, address, contact details, and any other relevant identification information.
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If applicable, provide the name and contact information of your designated individual or emergency contact. This person should be someone who is aware of your medical history and can act on your behalf in case of an emergency.
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