Take the stress out of workman’s compensation claims by completing your company’s paperwork in advance. Once we have your company’s information on file, all you need to do is send your employee to Liberty Urgent Care with a claim no. from your workman’s compensation insurance provider. Save time, let us help you with your workman’s compensation medical treatment. Complete the forms below and fax them to Liberty Urgent Care or contact us at 816-415-8855 for more information.

Workman’s Compensation Medical Forms

We also offer additional services for employers including routine physicals and drug screening.

Employee Information

The first step in gaining treatment for a work related injury is to notify your employer. In order to correctly bill your company’s workman’s compensation insurance provider, we need workman’s compensation forms completed by your employer. The forms include your personal information along with the claims adjuster and claim number from your company’s workman’s compensation insurance provider. By following these steps prior to medical treatment, you will not be liable for the medical bills.