Loading
Get Nc Form 25p 2020-2026
How it works
-
Open form follow the instructions
-
Easily sign the form with your finger
-
Send filled & signed form or save
How to fill out the NC Form 25P online
The NC Form 25P is crucial for documenting charges related to drugs in workers' compensation cases. This guide will provide you with step-by-step instructions on how to complete this form online efficiently and accurately.
Follow the steps to successfully complete the NC Form 25P online.
- Press the ‘Get Form’ button to retrieve the NC Form 25P and open it in your chosen editor.
- Begin filling out the form by entering the employee’s name and their employer's name in the designated fields.
- Complete the address section by providing the employer’s address, including city, state, and zip code.
- Enter the work telephone number, along with the employee's home telephone number.
- Fill out the last four digits of the employee's social security number and the date of birth.
- Specify the sex of the employee by choosing either ‘M’ for male or ‘F’ for female.
- List the name of the drug and the prescription number in the appropriate section.
- Document the total amount charged for the drugs provided.
- Certify that the drugs listed are related to the worker's compensation injury by signing the form.
- Indicate whether the employee should be reimbursed by selecting ‘Yes’ or ‘No’ for both the employee and the drug store.
- Ensure that all required information is complete and double-check for accuracy before proceeding.
- Save changes, download a copy of the form, print it, or share it as needed for submission.
Complete your NC Form 25P online today for a seamless filing experience.
Form 25T - This is a form to List an Itemized Statement of Charges for Travel. Employees are entitled to reimbursement for mileage if the employee travels 20 miles or more round trip for medical treatment. Form 24 - This is an Application to Terminate or Suspend Payment of Compensation.
Industry-leading security and compliance
US Legal Forms protects your data by complying with industry-specific security standards.
-
In businnes since 199725+ years providing professional legal documents.
-
Accredited businessGuarantees that a business meets BBB accreditation standards in the US and Canada.
-
Secured by BraintreeValidated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.