Scan this QR code to use this paper checklist on your smartphone or tablet or
visit
https://safetyculture.com/
Title Page
DECLINATION OF MEDICAL TREATMENT
I understand that I am declining medical treatment for a work related injury at this time. By declining medical treatment at this time, I am not forfeiting my right to seek medical treatment at a later date if I feel my condition persists or gets worse.
The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions.
The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice.
You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction.
You should independently determine whether the template is suitable for your circumstances.
