Get Function Report - Adult - Form Ssa-3373-bk

Completing the FUNCTION REPORT - ADULT - Form SSA-3373-BK is a crucial part of providing information for disability claims. This guide will walk you through the steps necessary to fill out the form accurately and effectively online.

Follow the steps to complete the form for your disability claim.

1. Use the 'Get Form' button to access the SSA-3373-BK and open it in your chosen editor.
2. Begin with Section A: General Information. Fill in the name of the disabled person, their Social Security number, the date, and a daytime telephone number where they can be reached.
3. Indicate the type of residence in Section A. Check the appropriate box to describe where the person lives, such as a house, apartment, or nursing home.
4. In Section B: Information About Daily Activities, describe the person's daily routine from waking up to going to bed. Provide detailed insights into personal care, meal preparation, and any house or yard work they may complete.
5. Answer questions regarding care for others or pets, including who they care for and the specific tasks involved.
6. Inquire about social activities in Section B, detailing interactions with friends and family, and list any places the person visits regularly.
7. Section C: Information About Abilities requires you to check items affected by the person's conditions and explain how those conditions impact their abilities.
8. Complete Section D: Remarks for any additional information that did not fit into the previous sections. Use this area to clarify responses or provide further context.
9. Ensure to provide the name and address of the person completing the form on Page 8 before saving your changes.
10. Once completed, you can save changes, download, print, or share the form as needed.

Submit your completed FUNCTION REPORT - ADULT - Form SSA-3373-BK online to ensure timely processing of your disability claim.