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- Click ‘Get Form’ to open the printable form OWCP 915 in the editor.
- Begin by filling out your personal information. Enter your name, OWCP file number, address, and telephone number clearly in the designated fields.
- Next, provide the provider information. Include the name of the doctor’s office or medical supply company where you incurred expenses, along with a description of the charge and date of service.
- Indicate the amount you paid for each service and ensure you check 'YES' or 'NO' regarding proof of payment for each item.
- Finally, certify that all information is correct by signing and dating the form at the bottom before submitting it.
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