Medical Forms Order Form {3210}

3210 - WORKERS’ COMPENSATION MEDICAL FORMS ORDER FORM. This form is used by individuals or organizations to request printed copies of specific medical forms related to Oregon workers’ compensation claims. The form collects the requester's name, company, address, and phone number, along with the quantity of each form needed. Available forms include the “Worker’s and Health Care Provider’s Report for Workers’ Compensation Claim” (Form 440-827), its Spanish version (Form 440-827s), and the “Request for Administrative Review of Medical Issues” (Form 440-2842). Limited quantities of some forms are available for shipment, and only one copy of the review request form will be shipped with the expectation that additional copies will be reproduced by the requester. Completed order forms must be mailed or faxed to the Workers’ Compensation Division's Operations Section – Publications unit. www.FormsWorkflow.com