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ALLIANCE TREATING DOCTOR CHANGE REQUESTNotice to injured worker: You have the right to choose an initial treating doctor from the Alliance list of medical providers. Within the first 60 days of treatment,
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The ALLIANCE TREATING DOCTOR CHANGE REQUEST is a fillable form in MS Word extension needed to be submitted to the required address in order to provide certain information. It must be filled-out and signed, which can be done manually in hard copy, or using a certain software such as PDFfiller. This tool helps to complete any PDF or Word document right in the web, customize it depending on your purposes and put a legally-binding e-signature. Right after completion, user can send the ALLIANCE TREATING DOCTOR CHANGE REQUEST to the relevant receiver, or multiple ones via email or fax. The template is printable too from PDFfiller feature and options proposed for printing out adjustment. In both digital and physical appearance, your form should have a clean and professional look. Also you can turn it into a template to use later, so you don't need to create a new blank form again. You need just to amend the ready form.

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Alliance treating doctor change refers to the process of updating or changing the designated doctor who is responsible for providing medical treatment within an alliance network.
The injured party or their authorized representative is required to file the alliance treating doctor change.
To fill out alliance treating doctor change, one must complete the required form provided by the insurance company, include the necessary information about the new treating doctor, and submit it within the deadline.
The purpose of alliance treating doctor change is to ensure that the injured party receives proper medical treatment from a designated doctor within the alliance network.
The information required to be reported on alliance treating doctor change includes the name and contact information of the new treating doctor, the reason for the change, and any relevant medical records.
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