Get Aps Attending Physician Statement Form

Filling out the Aps Attending Physician Statement Form accurately is crucial for the timely processing of your short term disability application. This guide provides clear and detailed instructions to help you complete the form efficiently online.

Follow the steps to complete the form effectively.

1. Click ‘Get Form’ button to retrieve the form and open it for editing.
2. Begin with the 'Claimant Information and Authorization' section, ensuring all personal details are entered accurately, including last name, first name, employer name, personal health care number, date of birth, and home phone number.
3. Next, provide the first day of absence, home address, manager’s name, and manager’s phone number.
4. In the provided space, succinctly describe the reason for absence from work.
5. Sign the authorization statement to allow medical information to be shared with Unistar Special Risks Inc., and include the date signed.
6. The 'Physician Questionnaire' will need to be completed by the attending physician. This section enables the physician to provide necessary medical details including diagnosis, extent of symptoms, and treatment history.
7. Ensure the physician includes all relevant medical history and findings, especially if there are any objective signs related to the current condition.
8. The physician is also required to indicate whether the condition is pregnancy-related, if it is work-related, and if prior similar conditions have occurred.
9. All information about treatments, medications, and the patient's capabilities should be detailed by the physician, including the anticipated return to work date and any updated work limitations.
10. Finally, once both parts of the form are completed, ensure to save your changes, and then download, print, or share the form as needed.

Complete your Aps Attending Physician Statement Form online today for a smooth application process.