COHE Forms & Resource Links

Clinical Occupational Health Best Practices

An efficient job aid for providers, support staff, medical records, billing and administrators as a quick glance guide describing each step of the Occupational Health Best Practices in a clinic setting.

Emergency Department Occupational Health Best Practices

An efficient job aid for providers, support staff, medical records, billing and administrators as a quick glance guide describing each step of the Occupational Health Best Practices in a ED setting.

L&I Activity Prescription Form

The APF is to be completed by the COHE provider on initial and follow-up visit when the injured worker has not returned to full duty. Completion of this form allows COHE providers to receive enhanced fees using billing code 1073M.

Guide: Barriers to Return-to-Work

Providers use the checklist as a guide to assist in evaluation of patients who are at risk of long term disability, on time loss, or when a light duty Return-to-Work (RTW) attempt was not successful.

Attending Provider's Return to Work Desk Reference

A helpful reference for for medical providers interested in more resources about Return to Work best practices.

Employer Job Description Form

An L&I form to be completed by employer of record to describe tasks and physical demands for restricted/modified duty jobs to facilitate return-to-work. Provider completes second page when presented by employer, employer representative, claim manager or vocational rehabilitation counselor.