6.19.19 – California Predesignation of Personal Physician Forms

Wednesday, June 19, 2019

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California Predesignation of Personal Physician Forms

In regard to yesterday’s hotline, we have received an influx in calls and emails from our membership asking where to find the form. APFA has provided direct links to assist in the completion of the forms.

Information can be found at the following link on Jetnet.

California Time of Hire Pamphlet and Pre-Designation Provider Instructions

If you would like to have a predesignated doctor on record this form must be filled out and emailed. Here is the direct link to the DWC Form 9783 from the APFA Website.

Click here for DWC Form 9783

Once Completed, please email this form to providerrelations@harborsys.com

Click here to view yesterday’s hotline

In Unity,

Bellia Peckson
APFA National IOD Chair
iod@apfa.org

1004 West Euless Boulevard
Euless, Texas 76040

Phone: (817) 540-0108
Fax: (817) 540-2077

 

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