Get Epl3 - Medical Report Form - Justice Gov

Filling out the EPL3 - Medical Report Form is an essential process for individuals involved in low value personal injury claims. This guide provides clear, step-by-step instructions to help you complete the form accurately and efficiently online.

Follow the steps to successfully complete the EPL3 - Medical Report Form.

1. Press the ‘Get Form’ button to access the EPL3 - Medical Report Form. Open the form in your chosen online editor.
2. In Section A, provide the claimant’s details including date of birth, full name, occupation, address, and postcode. Indicate whether medical records were provided and confirm if photo ID has been verified.
3. Detail any necessary medical history including past injuries or treatments. Specify the age of the claimant at the time of the accident and the date of examination.
4. Move to Section B and briefly describe the accident or exposure, listing symptoms and treatments. State if the claimant was treated as an inpatient or outpatient.
5. Include details about ongoing symptoms as reported by the claimant during the examination.
6. In Section C, provide information about the claimant’s employment or education status at the time of the incident, including any absences, part-time work, or light duties.
7. State the impact of the injury on the claimant’s daily activities, hobbies, and general state of mind.
8. In Section D, document any relevant past medical history and findings from the examination. Clearly state any restrictions arising from the accident or exposure.
9. Offer an opinion on the diagnosis, prognosis, and potential future treatment needs within Section D, based on the findings and claim aspects.
10. In Section E, specify any further treatment and rehabilitation that may be required by the claimant.
11. Complete Section F by signing the statement of truth, confirming the accuracy of your information and opinions while including the date.
12. Finally, review the completed form for accuracy. Save your changes, download, print, or share the form as needed.

Begin the process of completing your EPL3 - Medical Report Form online today.