Georgia
Workers Comp
Last updated: 10/28/2024
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Description
INITIAL REGISTRATION FOR REHABILITATION SUPPLIER or QUALIFIED CASE MANAGER. This form is used for individuals seeking to register as rehabilitation suppliers or qualified case managers with the Georgia State Board of Workers' Compensation. The application requires the submission of relevant certifications, personal information, educational background, and work history. It ensures that applicants meet the necessary certification requirements and have experience in workers' compensation. The form includes a $100 application fee and stipulates that any misrepresentation may lead to rejection or revocation of registration. www.FormsWorkflow.com
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