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WC Employee Release Medical Claim Information Form revised

PDF • 139.81 KB - April 10, 2026

Document Entity Terms

First Published

June 13, 2016

Last Updated

March 13, 2019

Mailing Address: MSC 1331, Raleigh, NC 27699-1331
Phone Number: 984-236-0800

This form can be used when members of the public seek information under the Public Records Act.