If you are submitting your care to Worker's Compensation Injury, you will need to fill out one of these forms for your first visit.
For patients in Oregon:
To complete the form:
1. Download the form based on your location and language
2. Fill each out. You can either use a pdf editor to select your answers digitally or print the document and take a picture of your answers.
3. Respond to the email from "firstname.lastname@example.org" with your attached documents
For patients in Washington:
Go to this url, https://secure.lni.wa.gov/home/signup.aspx, to fill out the form.
At this time, ZoomCare is not able to bill Worker's Compensation in Idaho and Colorado.