Forms

First Prescription Forms - All States

The form allows injured workers to fill their first prescription without having to pay for it out-of-pocket and seek reimbursement later. It should be given to an injured worker as soon as he or she reports the injury.
SeaBright Temporary Prescription Services (English & Spanish)

California

BrightCure Managed Provider Network:
Enrollment Instructions
Find a California Medical Provider

State-Mandated MPN Notifications:
California requires employers to post information regarding the medical care of employees injured at work and their benefits through an MPN
Initial Written Employee Notification RE: Medical Provider Network (English)
Initial Written Employee Notification RE: Medical Provider Network (Spanish)

MPN Implementation Notice:
California requires employers to notify employees that the company is participating in a medical provider network.
Employee Implementation Notice of SeaBright BrightCure Customized MPN

Employee Receipt of Information:
Acknowledgement of Receipt of BrightCure MPN Information (English)
Acknowledgement of Receipt of BrightCure MPN Information (Spanish)

Texas

Texas BrightCure Healthcare network:
Employee Information Materials (English)
Employee Information Materials (Spanish)