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STATE OF WEST VIRGINIA STATE AGENCY WORKERS COMPENSATION PROGRAM Send Completed Form To: Zurich Insurance PO Box 968044 Schaumburg, IL 60196-8044 FAX: 973-394-5262 PHYSICIAN STATEMENT OF PHYSICAL
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What is physician statement of physical?
A physician statement of physical is a form filled out by a doctor to assess an individual's physical health.
Who is required to file physician statement of physical?
Individuals who are applying for certain types of jobs or insurance policies may be required to file a physician statement of physical.
How to fill out physician statement of physical?
The form is typically filled out by a doctor after conducting a physical examination of the individual. The doctor will report their findings and assess the individual's overall physical health.
What is the purpose of physician statement of physical?
The purpose of the physician statement of physical is to provide an assessment of an individual's physical health for employment or insurance purposes.
What information must be reported on physician statement of physical?
The physician must report on the individual's overall physical health, any medical conditions or illnesses, and any recommended treatments or restrictions.
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