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LOS ANGELES COMMUNITY COLLEGES HUMAN RESOURCES 770 WILSHIRE BOULEVARD LOS ANGELES, CA 90017 LEAVE OF ABSENCE ATTENDING PHYSICIAN STATEMENT This form is to accompany all illness leave absences of six

How to fill out attending physician statement

How to fill out attending physician statement:

1. Start by obtaining the attending physician statement form from the relevant insurance company or organization. This form may also be referred to as an APS.
2. Begin by filling out the patient's personal information at the top of the form. This typically includes the patient's name, date of birth, address, and contact information.
3. Provide details about the patient's medical history. This includes any pre-existing conditions, past treatments, surgeries, and medications currently being taken. The physician may need to attach any relevant medical records or test results.
4. Indicate the reason for the attending physician statement. This could be for an insurance claim, disability evaluation, or other similar purposes. Clearly state the purpose and any relevant details.
5. The physician should provide a thorough description of the patient's current medical condition. This may include the diagnosis, prognosis, and any ongoing treatments or therapies being administered.
6. If necessary, the attending physician should include information about the patient's ability to perform specific tasks or activities. This could be relevant for disability evaluations or insurance claims related to loss of function.
7. The physician should sign and date the attending physician statement, verifying its accuracy and authenticity. It is important to ensure that all information provided is honest and complete.

Who needs attending physician statement:

1. Insurance companies often require an attending physician statement when processing claims. This helps them assess the validity of the claim and determine the extent of coverage.
2. Disability evaluators may request an attending physician statement to gather information about the patient's medical condition and functional limitations. This helps determine eligibility for disability benefits.
3. Attorneys may request an attending physician statement when representing clients in legal cases related to personal injury or medical malpractice. This helps establish the extent of the client's injuries and their impact on their well-being.

Please note that the specific requirements for an attending physician statement may vary depending on the purpose and the entity requesting it. It is important to carefully read and follow the instructions provided by the requesting party to ensure accurate and complete documentation.

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What is attending physician statement?

Attending physician statement is a document filled out by a patient's primary doctor that provides information on the patient's medical condition.

Who is required to file attending physician statement?

The patient's primary doctor or attending physician is required to file the attending physician statement.

How to fill out attending physician statement?

The attending physician must accurately report the patient's medical condition, treatment plan, and any other relevant information on the attending physician statement.

What is the purpose of attending physician statement?

The purpose of the attending physician statement is to provide an official medical evaluation of the patient's condition for insurance or legal purposes.

What information must be reported on attending physician statement?

The attending physician must report the patient's diagnosis, current treatment plan, prognosis, and any other relevant medical information on the attending physician statement.