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BWH Provider Services Declaration of Health Please be sure to have a physician of your choice complete the bottom half of this form before returning it to BWH Provider Services. The physician must
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Declaration of health is a form that individuals must complete to provide information about their current health status.
Anyone who is applying for certain insurance policies or benefits may be required to file a declaration of health.
To fill out a declaration of health, individuals must provide accurate information about their medical history, current health conditions, and lifestyle habits.
The purpose of the declaration of health is to assess the risk level of an individual for insurance companies or benefits providers.
Information such as pre-existing medical conditions, current medications, lifestyle choices, and family medical history must be reported on a declaration of health form.
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