top of page
Worker's Compensation Helpful Links

Form 25C

Authorization for Rehabilitation Professional to Obtain Medical Records of Current Treatment. Please fill out the form completely, sign it, and mail it to the rehabilitation professional named on the form.Click here for the Spanish Form 25C

Form 25N

Notice to the Commission of Assignment of Rehabilitation Professional. Please fill out this form completely, making sure to include the I.C. Number for the claim. Please submit to the Commission as directed on the form.

Rehabilitation

Management

Inc

bottom of page