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Dual Enrollment Co.
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chec the boxes:
Copy of Drivers License
Copy of completed CA 1 or CA2 and injury statement
Medical Records from previous offices you may have visited regarding this injury/claim
Medical Release Form(s)
Letters from DOL regarding your injury/claim
DOL Records Request Form
Change of Treating Form (if applicable)
Medical Office Welcome Packet
Medical Office History of Present Illness Packet