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Please fax the completed form to: Fax Number: 8664115613 The Hartford P.O.Box 14301 Lexington, KY 405124301 Clear Form ATTENDING PHYSICIAN 'S STATEMENT OF CONTINUED FUNCTIONALITY To be completed by.

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Typically, an APS includes places to indicate diagnoses, currently prescribed medication, and the length and extent of your treatment relationship with your treating medical provider.

An APS is one of the primary ways an insurance company obtains information about the severity of your medical condition and your treatment history. The APS typically contains a series of questions for a treating medical provider to complete.

Who completes an Attending Physician Statement? In order to be effective, an Attending Physician Statement must be completed by a doctor who knows you in person — your insurer or agency will reach out to get information from a physician who has either treated you in the past or is currently providing treatment.

APS (Attending Physician Statement) is a form required by insurance companies whenever applying for insurance. The form is filled by a physician illustrating the exact medical status of the insured person and if he is suffering any medical condition that conflicts with the insurance plan.

Get an attending physician's statement If the underwriter still has questions after looking over the results from your medical exam, they might request an attending physician's statement or APS. You can get one from your doctor, and it's a summary of your health and medical history.

An Attending Physician Statement (APS) is a form questionnaire from the insurance company that your treating doctor must complete. The purpose of the APS is for your doctor to certify your inability to work.

You might be requested to approach your doctor to fill out the Attending Physician Statement or the carrier may send it directly.

What is an APS? “The Attending Physician Statement is a summary of your health condition, written from a doctor or medical facility that either has treated or is currently treating someone that is seeking life insurance,” explains Paya Schlass, Customer Success Manager at Haven Life.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Content Takedown Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232