Arkansas requires Form 3 or a narrative medical report for every compensable workers' compensation case. The treating physician marks it as a first, progress or final report and records the accident, diagnosis and treatment, prognosis, work status with any temporary restrictions and, at the end of the healing period, the maximum medical improvement date and any permanent impairment rating.
The treating physician completes both sides and signs with license state, date of Arkansas licensure and license number. A carrier, self-insured employer or TPA may pre-print its name and address at the top.
Download the current version from the source each time; forms change without notice.
Physician's Report
A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.
Vero is not affiliated with, or endorsed by, the agencies and insurers listed here. Read our editorial policy.
Yes. The Arkansas Workers' Compensation Commission requires Form 3 or a narrative medical report for all compensable cases. A narrative should still cover what the form asks: diagnosis, treatment, prognosis, work status and restrictions, and the MMI date and impairment rating when treatment ends.
The back covers disability. Temporary disability options state when the claimant can return to work, with or without restrictions on standing, sitting, lifting or hours. Permanent disability options record no impairment, the MMI date, a rating to the body as a whole or to a body part, disfigurement or permanent total disability.
The medical provider sends it to the company handling the case for the employer, which may be the insurance carrier, a self-insured employer or a third party administrator. That company may have pre-printed its name and address in the top corner of the form.