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Forms for Injured Firefighters
State of Nevada
C-1 – Formally document the injury
C-4 – Request compensation
D-36 – Request for Additional Medical Information and Medical Release
D-39 – Physician’s and Chiropractor’s Certification of Disability
Other forms
Clark County
Outline for Appeals Process
Preferred Provider Directory
Worker’s Comp Education Booklet
Physician Disability Statement
City of Las Vegas
Accident / Injury Treatment Report
Health Hazard Exposure
Supervisor Accident Investigation Report
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