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Client Forms

Medical Release

Workers' Compensation Claim Form (DWC-1)

Unrepresented QME Form

Letter to Employment Development Department

Medical Mileage Reimbursement

Mileage Rate Chart

2010 Mileage Form

Jan - June 2011 Mileage Form

July - Dec 2011 Mileage Form

2012 Mileage Form

2013 Mileage Form

2014 Mileage Form

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Contact Information

Fowler & Ball Attorneys at Law
150 N. Pine Street
P.O. Box 540
Ukiah, CA 95482
Phone: 707-621-8533
Fax: 707-462-2731
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Home
Attorneys
Workers' Compensation Process
Getting Medical Treatment
Workers' Compensation Information
Client Forms
Links
FAQs
Contact

Fowler & Ball serves clients in Mendocino County, Lake County and elsewhere in Northern California, including Ukiah, Lakeport, Clearlake and Fort Bragg.