Get Lsu Health Shreveport Impairment Certification

This guide provides clear, step-by-step instructions for filling out the LSU Health Shreveport Impairment Certification online. By following these steps, you can ensure that the form is completed accurately and efficiently.

Follow the steps to successfully complete the LSU Health Shreveport Impairment Certification form.

1. Click the ‘Get Form’ button to obtain the LSU Health Shreveport Impairment Certification and open it in your preferred document editor.
2. Fill in the date of request at the top of the form, followed by entering your handicapped mobility card or placard number. Ensure this information is accurate to avoid delays.
3. Provide your name and employee ID in the respective fields. It is essential to enter your details exactly as they are registered.
4. Indicate the registered parking lot assignment, followed by the expiration date of the certification, using the formats provided.
5. In the physician certification section, check the appropriate duration of impairment that applies to you: lifelong or total impairment, extended impairment, or temporary impairment. Fill in any necessary duration information, such as the number of months or weeks, if applicable.
6. Check all conditions that apply to your mobility impairment. This might include your ability to walk, use of assistance, or specific health conditions as listed on the form.
7. After completing the necessary sections, ensure the physician signs and dates the form. Include their address and phone number.
8. Once all required fields are filled and checked, save your changes. You can then download or print the completed form for submission or sharing.

Complete your LSU Health Shreveport Impairment Certification form online today for a smooth processing experience.