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Free QME Form 102 Template – Register for the QME Competency Exam

Download the QME Form 102 template for free. Use this form to register for the Qualified Medical Evaluator (QME) competency exam in California.

Free Download

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.

How to Use QME Form 102

Tap to download the form 102 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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