Free QME Form 102 Template – Register for the QME Exam
The QME Form 102 is the official registration form for the Qualified Medical Evaluator (QME) competency exam in California. Physicians must complete this form to sign up for the exam, which is required to become a certified QME and perform medical evaluations in workers’ compensation cases.
Why Use QME Form 102?
This form is necessary for any physician who wants to become a QME and:
- Conduct medical evaluations in California workers’ compensation cases.
- Provide expert opinions on work-related injuries and disabilities.
- Meet the legal requirements set by the Division of Workers’ Compensation (DWC).
Who Needs The QME Form 102?
This form is required for:
-
- Doctors (MDs, DOs, DCs, psychologists, acupuncturists, podiatrists, etc.) who want to qualify as a QME.
- Physicians preparing to take the QME competency exam to start evaluating injured workers.
Download the Free QME Form 102 Template
Get started on your path to becoming a Qualified Medical Evaluator! Download the free Form 102 template now and register for the QME competency exam easily.
Template Categories
California
General
How to Use the Templates
- Tap to download the Specialist Medical Opinion Referral form for free from this page and type in your email ID.
- Download the form from your inbox.
- Fill in your details, including your name, medical license number, and exam date selection.
- Submit the completed form to the DWC Medical Unit as instructed on the form.
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