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|Title||Attending Physician's Report of Accident|
|Purpose||Pursuant to the Corrections and Conditional Release Regulations, this form is to be completed by the Attending Physician of the claimant in order to provide a diagnostic and prognostic. The completed form should be submitted to the Federal Workers Compensation Service (FWCS).|
Returning the Form|
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|Employment and Social Development Canada|
ATTENDING PHYSICIAN'S REPORT OF ACCIDENT
PDF: ESDC-LAB1073, 205 KB, printed on 1 pages (8.5x14)
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