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Form c 42 2026
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- Click ‘Get Form’ to open it in the editor.
- Begin by entering the physician's name, telephone number, and office address in the designated fields. Ensure accuracy as this information is crucial for your medical treatment.
- Continue filling out the remaining sections for additional physicians if necessary. You can list up to five physicians or chiropractors as per your employer's provided panel.
- Select your chosen physician from the list and enter the date of selection, along with the date of injury and appointment.
- Complete the employer and employee details, including names, addresses, and signatures. Make sure all information is correct to avoid any issues with your workers' compensation claim.
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