Follow the steps to successfully complete the form.

1. Click the ‘Get Form’ button to access the document and open it in your preferred editor.
2. Begin by filling out the 'Name and Address' section at the top of the form, capturing your details in the required fields provided.
3. In the 'Case Identification' section, enter the relevant record and case numbers as necessary, ensuring accuracy for proper tracking.
4. Proceed to the 'Medical Assessment Form' section. Fill in the client's name, date of birth, phone number, and address, taking care to spell everything correctly.
5. If applicable, complete the 'Confirmation of Pregnancy' section by providing the expected delivery date, if relevant to the assessment.
6. In 'Section I', complete the medical provider information thoroughly. This includes the printed name, medical license number, and contact details of the relevant healthcare provider.
7. Ensure that the medical provider certifies the information is true by providing their original signature and date of completion.
8. Move to 'Section II' to evaluate the client's employability. Select the appropriate checkbox based on the client's capabilities and provide necessary details regarding accommodations if applicable.
9. Complete the required information pertaining to the client's treatment plan, prescribed medications, and therapy necessary to aid in employment capabilities.
10. Continue to 'Section III' by listing the client’s diagnoses, including appropriate ICD-9 codes, and explaining how each affects their ability to work.
11. Finally, review and save all changes made to the form. You can then download, print, or share the completed document as required.

Complete the Ember Learn About Holocaust - DigiFind-It online to ensure your documentation is current and accurate.