Forms Catalog Document - LS1 :-: ESA :-: Request for Examination and/or Treatment

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Request for Examination and/or Treatment

The LS-1 is used by employers to authorize medical treatment for injured workers and by physicians to report findings of physical examinations and treatment recommended.

Form #: LS 1
Agency: Department of Labor
Bureau: Employment Standards Administration
Common Name: Request for Examination and/or Treatment

	TYPE	PAGES	SIZE (KB)	CAPABILITY	WHAT'S NEEDED
	Form Only	2		[3] Fillable + Printable	Adobe Reader Download

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