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Get a Form or Publication - Washington State Department of 2025

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The document is a Statement for Pharmacy Services that outlines the process for injured workers to request reimbursement for prescription costs related to their workers' compensation claims. It includes instructions on completing the form, required information such as worker and pharmacy details, prescription specifics, and emphasizes the need for receipts. The statement must be submitted within 12 months of service, and it clarifies that private insurance co-payments are not reimbursed.

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Income tax forms: The State of Washington does not have a personal or corporate Income Tax. Warning: to protect against the possibility of others accessing your confidential information, do not complete these forms on a public workstation.

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Get a Form or Publication - Washington State Department of 2025

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