Workers' Compensation, RI Dept. of Labor and Training
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Medical Forms

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Table is sortable by column

Medical Fee Schedule Order Form - Please see our Medical Fee Schedule Information Page

Form Title
Form Number
Date Revised
Purpose
PDF
Excel
Notification of Claim of Compensable Injury  DWC-29 04/2002 Purpose DWC-29  

Physician's Notice of Release to Work

DWC-27/28

07/2009 Purpose DWC-27/28  

Request for Additional Palliative Care

DWC-40 04/2005 Purpose DWC-40  

For additional workers' compensation medical forms, please visit the Medical Advisory Board. If you have questions or comments about medical forms, please contact the Education Unit's Information Line at (401) 462-8100 option 1 or email WCEdcUnit@dlt.ri.gov

 



 
RI Department of Labor and Training
Workers' Compensation
Center General Complex
1511 Pontiac Avenue, Cranston, RI 02920


Phone: (401) 462-8100
Fax (401) 462-8105
TTY via RI Relay: 711
1/27/14 MDF
State Seal
  DLT is an equal opportunity employer/program. Auxiliary aids and services available upon request