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This guide provides comprehensive instructions on how to fill out the University of Virginia's Workers’ Compensation Attending Physician Panel form for faculty and staff. By following the outlined steps, you will ensure a smooth and accurate submission of your form online.

Follow the steps to complete the form accurately and efficiently.

1. Press the ‘Get Form’ button to access the Workers’ Compensation Attending Physician Panel form and begin the process of filling it out.
2. In the designated area, select one physician from the provided panel of physicians. Ensure that you choose a physician who is listed, as failing to do so may impact your compensation benefits.
3. Complete the section for your signature by providing your name, signature, and the date you are signing the form. Below this, fill in the date of your accident in the specified field.
4. Review all entered information for accuracy. Make sure that your chosen physician's name is clearly written and that all fields are correctly filled.
5. Once you have confirmed that all details are correct, save the changes made to the form. You may also have the option to download, print, or share the form for submission.
6. Submit the completed form by returning it to the University Human Resources Benefits Division at the address provided, or by faxing it to the designated number.

Complete the Workers’ Compensation Attending Physician Panel form online to ensure prompt processing of your claim.