Order Form For Publications
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Order Form (Medical Fee Schedule And Law And Regulations) Form. This is a Kansas form and can be use in Workers Compensation.
Tags: Order Form (Medical Fee Schedule And Law And Regulations), K-WC 300, Kansas Workers Compensation,
KANSAS DEPARTMENT OF LABORwww.dol.ks.govORDER FORM FOR WORKERS COMPENSATION PUBLICATIONSK-WC 300 (Rev. )The following publications are available for download:Schedule of Medical Fees: www.dol.ks.gov/WorkComp/medfeesched.aspxLaws & Regulations book: www.dol.ks.gov/WorkComp/frmpub2.aspx PAYMENT OPTIONS225 Personal or Business Check: The Kansas Department of Labor is now using KanPay to process checkpayments for security purposes. Please add $1.50 to the product total for a processing service charge.Mail your check payable to the Kansas Division of Workers Compensation to:Kansas Department of LaborDivision of Workers Compensation401 SW Topeka Blvd., Suite 2Topeka, KS 66603-3105225 Credit Card: The Kansas Department of Labor is now using KanPay to process credit card payments for security purposes. A 2.5% service charge will be added to the product total. You will receive aKanPay receipt of payment by email. VISA � MasterCard Card # Discover � American Express Expiration Date: MO YR Name as it appears on card: Or call: Division of Workers Compensation (785) 296-4000 FAX: (785) 296-0839 Schedule of Medical Fees 226 , 201 $ copies @ $ per copy postpaid Laws & Regulations 226 J 1, 2017 copies @ $ per copy postpaid $ � Product Total $Service Charges: (Select only one payment option listed below)The payment option not used should be set at zero. If paying by check, $1.50 will be added to the Product Total. $ If paying by credit card, a $ $ **Purchaser222s name: Business name: *Mailing address: *City: *State: *ZIP: *Phone: *Email: ( ) American LegalNet, Inc. www.FormsWorkFlow.com
