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Order Form (Medical Fee Schedule And Law And Regulations) K-WC 300 - Kansas

Order Form (Medical Fee Schedule And Law And Regulations) Form. This is a Kansas form and can be used in Workers Compensation .
 Fillable pdf Last Modified 8/9/2012
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KANSAS DEPARTMENT OF LABOR www.dol.ks.gov ORDER FORM FOR WORKERS COMPENSATION PUBLICATIONS K-WC 300 (Rev. 6-12) These publications are also available at: www.dol.ks.gov/WC/Medfeesched.html www.dol.ks.gov/wc/frmpub2.html or Schedule of Medical Fees ­ January 1, 2012 Excel files (code tables only) in Zip file ...... @ $40.00 $______________ Laws and Regulations ­ July 1, 2007 Laws and Regulations Book....................... ______ copies @ $12.00 per copy NOTICE: The Kansas Department of Labor will not publish a new law book until fall 2012. $______________ TOTAL $______________ Purchaser's name: ________________________________________________________________ Business name: __________________________________________________________________ Mailing address: __________________________________________________________________ City: _____________________________________ State: _______ ZIP : ___________________ ( ) Phone:_____________________________ Email: ______________________________________ Please send check or money order payable to the Kansas Division of Workers Compensation to: Kansas Department of Labor Division of Workers Compensation 401 SW Topeka Blvd., Suite 2 Topeka, KS 66603-3105 Orders using Visa/Mastercard should be called to: Division of Workers Compensation (785) 296-4000 American LegalNet, Inc. www.FormsWorkFlow.com
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