Oregon
Workers Comp
Medical
Last updated: 6/4/2025
Nurse Practitioners Statement Of Authorization {2882}
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Description
NURSE PRACTITIONER’S STATEMENT OF AUTHORIZATION. This form is used by the Oregon Workers' Compensation Division to authorize nurse practitioners to treat patients with work-related injuries under Oregon law. By completing and signing the form, a nurse practitioner certifies that they are licensed by the Oregon State Board of Nursing and have reviewed the Nurse Practitioner’s Handbook and accompanying informational materials. The form requires the practitioner to provide contact details, license and identification numbers, and a signature indicating agreement to comply with applicable regulations. www.FormsWorkflow.com
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