Releases, Notices & Documents
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Please click LIMITS TO CONFIDENTIALITY (New Client) button, above to sign and submit authorizations required to conduct evaluation. (Includes Telemedicine Release)
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Please click BWC Initial Therapy Client Releases button, above to sign and submit authorizations required to begin treatment of workers injured in Ohio. (Includes Telemedicine Release)
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Please click LIMITS TO CONFIDENTIALITY (Existing Client) button, above to sign and submit authorizations required to conduct evaluation. (Includes Telemedicine Release)
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Please click Telemedicine Release button, above to sign and submit authorization.
[REQUIRED to receive telemedicince services: phone and/or virtual (video+audio)] |
| Telemedicine Release |
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