Mg 1 2026

1. Click ‘Get Form’ to open the mg 1 document in the editor.
2. Begin by entering the WCB Case # and Claim Administrator Claim (Carrier Case) # at the top of the form. This information is crucial for tracking your request.
3. In section A, fill in the Patient's Name, Date of Injury/Illness, Social Security No., and Patient's Address. Ensure accuracy as this data is essential for processing.
4. Next, provide the Employer's Name & Address and Insurer's Name & Address. If your employer participates in the Optional Prior Approval program, confirm their status on the WCB website.
5. Section B requires you to enter the Attending Doctor's Name & Address along with their WCB Authorization No., Telephone No., Fax No., and NPI No. This identifies who is making the request.
6. In section C, indicate the Treatment/Procedure Requested and Guideline Reference. Use appropriate codes for injuries or conditions as specified in the guidelines.
7. Finally, ensure that all required signatures are completed before submitting your form. You can send it directly from our platform for convenience.

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