We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use.
Click "here" to read our Cookie Policy. By clicking "Accept" you agree to the use of cookies. Read less
Read more
Accept
Loading
Form preview
  • US Legal Forms
  • Form Library
  • Independent Agency Forms
  • Independent Agency SSA Forms
  • Ssa-787 2010

Get Ssa-787 2010

Hese programs. SOCIAL SECURITY NUMBER A complete list of routine uses for this information is available in Systems of Record Notices 60-0089 and 60-0222. The notices, additional information regarding this form, and information regarding our programs and systems, are available on-line at www.socialsecurity.gov or at your local Social Security office. - PATIENT'S NAME PATIENT'S ADDRESS (Number and Street, City, State, and ZIP Code) PATIENT'S SOCIAL SECURITY NUMBER - - PATIENT'S DATE OF BIRTH .

This website is not affiliated with any governmental entity

How it works

  1. Open form

    Open form follow the instructions

  2. Easily sign form

    Easily sign the form with your finger

  3. Share form

    Send filled & signed form or save

How to fill out the SSA-787 online

The SSA-787 form is a vital document used to determine whether an individual can manage their Social Security benefits independently or requires a representative payee. This guide provides step-by-step instructions for filling out the SSA-787 online, ensuring a smooth and efficient process.

Follow the steps to complete the SSA-787 form accurately.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by filling in the identifying information, including the patient's name, address, social security number, and date of birth. Ensure that all provided details are accurate to avoid delays.
  3. In the section regarding the patient's capability to manage their benefits, answer the questions based on your professional assessment. For question 1, state the date of your last examination of the patient.
  4. Next, respond to question 2. Indicate whether the patient is capable of managing their benefits in their best interest. If you select 'No' or 'Unsure', provide a brief explanation as prompted.
  5. If you indicated 'No' in question 2, complete question 3 regarding any expected future capability for managing funds. Provide details as necessary.
  6. Fill in your information as the physician or medical officer, including your name, address, title, and contact number.
  7. Finally, review all the information provided for accuracy. Sign and date the form where indicated before submission.
  8. Once completed, save your changes, and you can choose to download, print, or share the form as needed.

Start filling out your SSA-787 form online today to ensure a timely assessment of benefits.

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.

Related content

physician's/medical officer's statement of ......
SOCIAL SECURITY ADMINISTRATION ... and has no bearing on disability determinations; SSA...
Learn more
Appendix C: Selected Forms | Informing Social...
U.S. SOCIAL SECURITY ADMINISTRATION. Physician's/Medical Officer's Statement of Patient's...
Learn more

Related links form

IL Kenwood Academy High School Parental Permission Form 2012 IL Land Evaluation Site Assessment System - Kendall County 2008 IL Lions Clubs International IAD603 2010 IL Marine Corps League Report of Officer Installation 2004

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
If you believe that this page should be taken down, please follow our DMCA take down processhere.

Industry-leading security and compliance

US Legal Forms protects your data by complying with industry-specific security standards.
  • In businnes since 1997
    25+ years providing professional legal documents.
  • Accredited business
    Guarantees that a business meets BBB accreditation standards in the US and Canada.
  • Secured by Braintree
    Validated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.
Get SSA-787
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
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
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 WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
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
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
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
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 WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
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
SSA-787
This form is available in several versions.
Select the version you need from the drop-down list below.
2018 SSA-787
Select form
  • 2018 SSA-787
  • 2010 SSA-787
  • 2002 SSA-787
  • 1992 SSA-787
Select form