Contents of the Tuolumne JPA Physician Packet:

1. Structured Return to Work Brochure
2. Treatment Referral Form
3. Supervisor's Report of Employee Injury
4. Modified Assignment Protocols
5. Medical Authorization Form (pdf)
6. Physician Information Sheet
7. Work Status Report
8. Employers Report of Occupational Injury (Form 5020)
9. Workers' Compensation Claim Form (DWC- 1)