Employees are must treat with Kaiser (with the exception of emergencies) unless they have a predesignation on file with Human Resources.
When filled out, this form must be downloaded, printed out, filled out completely, and signed. The Supervisor must ensure that this form is given to Human Resources/Risk Management.
You may attach the completed DWC1 form here or email it directly to [email protected]
The Supervisor Will Receive This Request in an email
This field is not part of the form submission.
* indicates a required field