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This application is submitted to: CONFIDENTIAL /PROPRIETARY California Participating Physician Reapplication, herein, this Healthcare Organization 1I. INSTRUCTIONSThis form should be typed or legibly
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The California Participating Physician is a document needed to be submitted to the required address in order to provide some information. It has to be filled-out and signed, which can be done manually in hard copy, or using a particular solution like PDFfiller. It lets you complete any PDF or Word document right in the web, customize it according to your needs and put a legally-binding electronic signature. Once after completion, user can send the California Participating Physician to the appropriate receiver, or multiple individuals via email or fax. The template is printable as well from PDFfiller feature and options proposed for printing out adjustment. In both electronic and in hard copy, your form will have a neat and professional look. Also you can save it as the template for further use, without creating a new blank form again. All you need to do is to edit the ready sample.

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California participating physician is a licensed medical doctor who has agreed to accept assignment under the California workers' compensation system.
Employers and insurance carriers are required to file the California participating physician form to designate a primary treating physician for injured workers.
The California participating physician form can be filled out by providing the necessary information about the designated primary treating physician, including their name, address, and contact information.
The purpose of the California participating physician form is to designate a primary treating physician for injured workers in the California workers' compensation system.
The California participating physician form must include the name, address, and contact information of the designated primary treating physician.
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