Get Health Care Provider Statement In Lieu Of Testimony. Rule 1.1901 Form 19

This guide provides a detailed overview of how to complete the Health Care Provider Statement In Lieu Of Testimony. Rule 1.1901 Form 19 online. It aims to support users in accurately filling out each section of the form while ensuring clarity and completeness.

Follow the steps to complete the form effectively.

1. Click the ‘Get Form’ button to access and open the form in a suitable editor.
2. Identify the sections relevant to the case. Begin by filling out the names of the plaintiff and defendant in the respective fields at the top of the form.
3. Enter the patient’s name along with the type and date of the incident that led to their care.
4. Proceed to answer the detailed questions regarding the patient's injuries, pre-existing conditions, and evaluations concerning their recovery. Ensure clarity and detail in your responses.
5. If additional pages are needed to fully respond to the questions, check the box and indicate the number of pages attached, ensuring each answer corresponds to the relevant question number.
6. Complete the oath and signature section by providing your name, as the health care provider, and signing the document, ensuring you also include the date of signing.
7. Continue to the attorney certificate section, where the attorney must list any communications regarding the patient, along with the date of each communication. Attach copies of written or electronic communications as necessary.
8. Finalize the attorney section by having the attorney print their name, sign, and date the document. Collect any additional contact information required.
9. Review the completed form for accuracy and completeness. Once verified, save the changes, and prepare to download, print, or share the form as needed.

Start completing your documents online to ensure accuracy and efficiency.