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INJURY CARE OF COLORADO Occupational Medicine and Workers Compensation 2801 Purcell St Brighton CO 80601 (p) 303.659.3199 (f) 303.558.8011 www.iccbrighton.com TODAYS DATE PATIENT INFORMATION LAST
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How to fill out injury care of Colorado:

01
Start by downloading the injury care of Colorado form from their official website or request a copy from their office.
02
Fill in your personal information at the top of the form, including your full name, address, phone number, and email address.
03
Next, provide details about the injury or accident that occurred. Include the date, time, and location of the incident, as well as a brief description of what happened.
04
If applicable, provide information about any witnesses present during the incident. Include their names, contact information, and a brief statement about what they saw.
05
Describe the nature of your injury and any symptoms you are experiencing. Be as specific as possible and include any medical diagnoses or treatment you have received.
06
Indicate if you have filed a report with any authorities, such as the police or workplace safety agency, and provide the details if applicable.
07
If you have sought medical treatment for your injury, provide the name and contact information of the healthcare provider or facility you visited.
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If you have any additional supporting documents, such as medical records, police reports, or witness statements, attach copies to the form.
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Review the completed form to ensure all information is accurate and legible. Sign and date the form before submitting it to injury care of Colorado.

Who needs injury care of Colorado:

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Individuals who have suffered an injury in Colorado and require medical attention can benefit from injury care of Colorado.
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This service is available to individuals of all ages, including adults and children.
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Injury care of Colorado can be beneficial for individuals who have been involved in work-related accidents, car accidents, slip and fall incidents, sports-related injuries, and other types of accidents.
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The services provided by injury care of Colorado can help individuals receive timely and appropriate medical care for their injuries, including diagnosis, treatment, rehabilitation, and ongoing support.
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It is recommended to contact injury care of Colorado as soon as possible after an injury occurs to ensure prompt and efficient care.
Remember to consult with a legal professional or the injury care of Colorado team for specific guidance and advice regarding your unique situation.
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Injury Care of Colorado is a program designed to provide medical treatment for injured workers in Colorado.
Employers in Colorado are required to file Injury Care of Colorado for their injured workers.
Injury Care of Colorado can be filled out online through the state's official website or submitted through mail.
The purpose of Injury Care of Colorado is to ensure that injured workers receive the necessary medical treatment and care they need.
Injury Care of Colorado requires information such as the injured worker's name, date of injury, employer information, and details of the injury.
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