Home
Forms Library
Form 123 - Physician's Initial Report of Work Injury or Occupational ...

Form 123 - Physician's Initial Report of Work Injury or Occupational ... 2025

Form 123 - Physician's Initial Report of Work Injury or Occupational ... Preview on Page 1

Show details

4.8 out of 5

116 votes

The document is an application form for injured workers seeking to change their healthcare provider. It requires details about the injury, previous doctors, and reasons for the requested change. The form must be submitted to the insurance carrier for approval, and it outlines the process for notifying both the applicant and the new doctor of the decision.

Here's how it works

01. Edit your form online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send it via email, link, or fax. You can also download it, export it or print it out.

How to edit Form 123 - Physician's Initial Report of Work Injury or Occupational ... online

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

With DocHub, making adjustments to your paperwork requires only some simple clicks. Make these quick steps to edit the PDF Form 123 - Physician's Initial Report of Work Injury or Occupational ... online for free:

Register and log in to your account. Sign in to the editor with your credentials or click on Create free account to examine the tool’s functionality.
Add the Form 123 - Physician's Initial Report of Work Injury or Occupational ... for redacting. Click on the New Document option above, then drag and drop the file to the upload area, import it from the cloud, or via a link.
Adjust your file. Make any adjustments required: add text and pictures to your Form 123 - Physician's Initial Report of Work Injury or Occupational ..., underline details that matter, erase parts of content and replace them with new ones, and add icons, checkmarks, and areas for filling out.
Complete redacting the template. Save the modified document on your device, export it to the cloud, print it right from the editor, or share it with all the parties involved.

Our editor is super intuitive and effective. Give it a try now!

See more Form 123 - Physician's Initial Report of Work Injury or Occupational ... versions

We've got more versions of the Form 123 - Physician's Initial Report of Work Injury or Occupational ... form. Select the right Form 123 - Physician's Initial Report of Work Injury or Occupational ... version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2019	4.8 Satisfied (116 Votes)

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What do I need to sign my [KEY] electronically?

Electronic document signing demands a software solution that works in compliance with data protection and eSignature standards. DocHub is a great tool for that, as it meets all the aforementioned requirements. Whatever method you prefer to sign your [KEY] in DocHub, your eSignature will be legally binding and court-admissible.

Can I sign my [KEY] while I edit it?

If you edit your [KEY] with DocHub, you will not need to look for other applications or services to sign it. An electronic signature is a component of DocHub’s extensive editing toolset, which enables you to apply changes in your form without jumping between platforms. Just complete your form, double-check the correctness of the information and place your electronic signature at the end to make it submission-ready within a few minutes.

Try more PDF tools