Maryland > Workers Compensation > Adjudication Claims
Subpoena Or Subpoena Duces Tecum Or Subpeona Duces Tecum For Medical Record H-08 - Maryland
| Subpoena Or Subpoena Duces Tecum Or Subpeona Duces Tecum For Medical Record Form. This is a Maryland form and can be used in Adjudication Claims Workers Compensation . |
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WORKERS' COMPENSATION COMMISSION 10 EAST BALTIMORE STREET BALTIMORE, MARYLAND 21202-1641 SUBPOENA SUBPOENA DUCES TECUM SUBPOENA DUCES TECUM for Medical Record* *Issuing Party must prepare & attach a Certificate of Service pursuant to the Annotated Code of Maryland, Health General, Section 4-306(b). Claimant versus WCC Claim Number Employer and Insurer ATTENTION: THIS FORM IS NO LONGER PRINTED IN DUPLICATE. IT IS THE RESPONSIBILITY OF THE PERSON ISSUING THE SUBPOENA TO MAKE DUPLICATE COPIES FOR THE SHERIFF'S RETURN. TO: Name Address City State Zip Code YOU ARE HEREBY COMMANDED TO PERSONALLY APPEAR AND/OR PRODUCE THE FOLLOWING: at (Hearing Location) on the day of ,20 at A.M./P.M. Subpoena requested by ; and any questions should be referred to: Address Date Issued Telephone: WORKERS' COMPENSATION COMMISSION Per Served and copy delivered on date indicated below Unserved, by reason of Date: SHERIFF'S RETURN SHERIFF WCC Form H-08 (4/2013) CLICK HERE TO CLEAR THE FORM American LegalNet, Inc. www.FormsWorkFlow.com
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