Washington Independent Medical Exam (IME) Template is a document that allows providers to conduct an independent medical examination for a patient in the state of Washington. This template guides the provider through the process of assessing the patient’s medical condition and determining their eligibility for treatment. The template includes sections for medical history, diagnoses, impairments, functional limitations, treatment plan, and prognosis. The provider can also include any additional information, such as medical records, that is necessary to complete the exam. There are three main types of Washington IME Template: Standard, Standard Plus, and Medical Necessity. The Standard IME Template is the most basic and contains the information necessary for the provider to establish a diagnosis and treatment plan. The Standard Plus Template offers additional information for more complex cases and includes sections for medications, laboratory results, and radiology reports. The Medical Necessity Template is the most comprehensive and contains all the sections of the Standard and Standard Plus Templates, plus additional information on the patient’s medical condition and prognosis.