Application For Registration Or Renewal As Organization Approved For Employment Of Qualified Rehabilitation Consultant Or Independent {R-24}

MN R-24 - QUALIFIED REHABILITATION CONSULTANT FIRM APPLICATION. This form is used by the Minnesota Department of Labor and Industry to register or renew the registration of firms that provide rehabilitation services to injured workers under the state’s workers’ compensation system. This form ensures that firms meet statutory and regulatory requirements by collecting detailed information about the business, including its legal structure, contact information, management and non-management staff, and proof of workers’ compensation insurance or a valid exemption. Applicants must identify at least one registered QRC on staff, disclose prior applications or registrations, and provide supporting documentation such as resumes, licenses, or certifications. The form also requires payment of a registration fee and notarized certification by an owner, officer, or manager affirming the accuracy of the information and agreeing to comply with Minnesota statutes and rules governing rehabilitation services. www.FormsWorkflow.com