Get Dshs Physical Functional Evaluation

The DSHS Physical Functional Evaluation is a crucial document that helps assess a person's ability to work and their eligibility for public assistance. This guide provides clear, step-by-step instructions on how to complete the evaluation online, ensuring you have the support you need during the process.

Follow the steps to successfully complete the evaluation online.

1. Select the ‘Get Form’ button to download the form and open it in your document editor.
2. Fill out the client information section, including the person's name, birth date, and client identification number. Ensure all information is accurate and up-to-date.
3. In the authorization section, specify the name of the examining professional who will release the information to DSHS. Indicate the validity period of the authorization.
4. Provide detailed subjective information by outlining the chief complaints, reported symptoms, and the onset date of the primary impairment. Include any relevant treatment history.
5. For the objective section, attach any required chart notes that detail examination findings. Describe any non-exertional limitations or restrictions the individual may face in the workplace.
6. Complete the assessment section by listing each diagnosis in the designated area and estimating their severity based on the provided scale from none to severe.
7. Indicate the level of work the client can perform, choosing from options like heavy, medium, light, sedentary, or severely limited, along with a duration estimate for current limitations.
8. Answer the substance abuse questions truthfully and provide treatment recommendations if applicable.
9. Finalize the report by listing any additional tests needed and treatment recommendations. Ensure to include the signature of the examining professional, their printed name, date of examination, and contact information.
10. After completing the form, make sure to save your changes, and download or print a copy for your records. You can also share the completed form as necessary.

Take the next step towards completing your DSHS Physical Functional Evaluation online today.