Skip to Page Content
Delaware.gov  |  Text OnlyGovernor | General Assembly | Courts | Elected Officials | State Agencies
 Photo: Featured Delaware Photo
 
 
 Phone Numbers Mobile Help Size Print Email

Department of Labor: Division of Industrial Affairs >> Office of Workers' Compensation

Check left menu for Updates and Revisions!!

DOWNLOAD FORMS


1.Health Care Provider Application for Certification
2. Employer's Modified Duty Availability Report
   - Blank Form and Instructions
   - Example
3. Physician's Report of Worker's Compensation Injury
   - Blank Form and Instructions
   - Example
4.Request for Utilization Review

 
Last Updated: Tuesday, 2-June-2009 13:34:22 EDT
site map   |   about this site   |    contact us   |    translate   |    delaware.gov