Get Medical Statement

Completing the Medical Statement online can streamline your request for essential medical information. This guide provides clear and supportive steps to help you accurately fill out the application.

Follow the steps to complete your Medical Statement request effectively.

1. Press the ‘Get Form’ button to access the application and open it in your preferred online editor.
2. Fill in the applicant information section. Provide your family name, given name, and date of birth in the required format (DD-MON-YYYY). Indicate your mailing address including province, city or town, country, and postal code if applicable. Ensure you enter your health services number (a 9-digit code) and provide a contact phone number.
3. Select the type of statement you require by marking either the physician statement or the hospital statement.
4. If applicable, complete Section 1 regarding the representative of the applicant. Indicate the name of the representative and circle the appropriate role (parent, guardian, trustee, power of attorney, or executor). Attach necessary documentation for the selected role if applicable.
5. In Section 2, if you wish to authorize a third-party agency to receive your medical statement, provide their name, company, and mailing address. Also, specify the start and end dates for this authorization.
6. Complete Section 3 by entering the time frame requested for your medical statement. Fill in both the start date and end date in the required format (DD-MON-YYYY).
7. In Section 4, sign the application. Ensure you include the date of your signature and circle your role as applicant, guardian, trustee, power of attorney, or executor. Remember, a witness is needed if you sign with an ‘X’ or a mark.
8. Review all entered information for accuracy. Once you are satisfied, save your changes. You can then download, print, or share the completed form as needed.

Start your Medical Statement application online today for a smoother processing experience.