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Get NCSU Supervisor’s Medical Treatment Authorization 2017-2024

Rescription Drug Deliver completed report to both: HR Benefits/University Leave Administration WorkersComp ncsu.edu 919.515.2151 (phone) 888.317.2890 (fax) Environmental Health & Safety AccidentReport ncsu.edu 919.515.7915 (phone) 919.515.6307 (fax) Supervisor: Please complete Section A and give to the injured employee to take with them to the authorized treating medical provider. This form authorizes their initial care. The remainder of the form is to be completed by the medical provider, an.

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