Get 02-227 Second Injury Fund Medical Quest Tnpmd - Summit

Filling out the 02-227 Second Injury Fund Medical Quest TNpmd - Summit form is an important step in the employment process, ensuring that necessary medical information is collected. This guide provides clear instructions to help you complete the form efficiently and accurately.

Follow the steps to successfully fill out your form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the name of the employer in the designated field, ensuring accuracy to avoid processing delays.
3. Next, fill in the employee’s name as it appears on official documents. Ensure that the spelling is correct.
4. Provide the employee’s Social Security Number. Ensure that this is a valid number, as it is crucial for identification purposes.
5. Fill in the employee’s height and weight in the specified fields, using the appropriate units.
6. Proceed to question 1, where you need to indicate any current or past medical conditions by selecting 'Yes' or 'No' for each listed item. If necessary, provide further details in the spaces provided.
7. Answer question 2 regarding previous workers’ compensation claims. If applicable, provide details about the incident, including the reason, date, and location of the injury.
8. For question 3, indicate whether you have received a disability rating. If 'Yes', enter the percentage and provide additional details.
9. Questions 4 to 8 ask about various injuries and surgeries. Answer carefully and provide details if affirmative responses apply.
10. Review all entries for accuracy and completeness. Check for any required signatures: the employee must sign and date the form, as well as the employer.
11. Once completed, save any changes. Download or print the form as needed, ensuring you keep a copy for your records.

Complete your documents online today to ensure timely processing.