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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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Form OWCP-915 can be used to seek reimbursement for expenses in regard to medical treatment, prescription medication and medical supplies. Please submit aRead more
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