Description | File Format |
---|---|
Workers' Compensation Complaint Form | HTML |
Employee Acknowledgment Form Samples | HTML |
Workers' Compensation Health Care Networks Forms
If the form is a fillable PDF, learn how to enable all fillable form features.
TDI Form Number | Description | File Format | Language |
---|---|---|---|
LHL705 | English | ||
LHL708 |
Workers' Compensation Network Access Plan Checklist WC Network Access Plan Checklist |
English | |
LHL720 |
Workers' Compensation Health Care Network Provider Contract Checklist |
English | |
LHL721 |
Workers’ Compensation Network Contract with Insurance Carrier Contract Requirements Checklist |
English | |
LHL722 |
Workers' Compensation Health Care Network Management Contract Checklist |
English | |
SN003 | English | ||
SN008 | English |
For more information, contact: MCQA@tdi.texas.gov