Get Primary Treating Physician's Progress Report - The Supply Center

Filling out the Primary Treating Physician's Progress Report is essential for ensuring that all necessary information about your patient's condition and treatment is documented accurately. This guide will assist you in navigating the online form, providing clear instructions on how to complete each section effectively.

Follow the steps to complete the form accurately

1. Click the ‘Get Form’ button to access the document and open it in your preferred editing platform.
2. Begin by checking the appropriate box or boxes that indicate the reason for submitting the report at this time, such as a periodic report or a change in treatment plan.
3. Fill in the patient's personal information, including their last name, first name, middle initial, sex, address, city, state, zip code, date of injury, date of birth, occupation, social security number, and phone number.
4. Provide the claims administrator's name, claim number, address, phone number, and fax number to ensure accurate processing.
5. Enter the employer's name and contact number in the designated fields.
6. Document the subjective complaints of the patient in the provided section. This should reflect their reported symptoms and concerns.
7. List the objective findings, including results from significant physical examinations, laboratory work, imaging studies, or other diagnostic tests.
8. Detail the diagnoses related to the patient's condition, including the ICD-9 codes for each diagnosis.
9. Outline the treatment plan, including treatments rendered to date, methods, frequency, and duration of planned treatments. Specify any necessary consultations, referrals, surgeries, and identify each provider involved.
10. Complete the work status section, indicating instructions for the patient regarding their return to work, including dates and any limitations or restrictions.
11. Sign and date the report, ensuring that you include your California license number and declaration confirming the accuracy of the report.
12. Review the entire form for completeness and accuracy. Once satisfied, you may save your changes, download the document, print it, or share it as required.

Start filling out your Primary Treating Physician's Progress Report online today to ensure timely and accurate documentation!