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Employee: Complete this section. The personal physician may sign the optional predesignation form (DWC Form 9783) in section 9783 as documentation of such agreement.The personal physician must agree to the pre-designation. Employer representative sign and date the Notice of Predesignation of Personal Physician to acknowledge receipt. Why Predesignation is Rare Complete the Pre-Designation of Personal Physician form prior to the injury;. Who will treat me if my industrial injury is a medical emergency? This is an optional form that can be used to notify your employer of your personal physician. One of the simplest ways to predesignate is to fill out DWC Form 9783 which you can find online. Instant access to fillable Microsoft Word or PDF forms.