Get the free Section 1 - Physician Information Section 2 - ontariorheum.ca

If maximum doses of and have not been tried details of the patient s intolerance or contraindication to these two agents must be given AND details of another DMARD tried in each one s place for at least 3 months should be provided. NAME OF DMARD DOSING REGIMEN START DATE END DATE REASON FOR DISCONTINUATION Details of intolerance contraindication or failure at maximum dose must be provided Physician Signature Mandatory CPSO Number Please fax the completed form and/or any additional relevant...

How to fill out section 1 - physician

How to fill out section 1 - physician

1. Step 1: Start by gathering all necessary information related to the physician, including their full name, contact details, and medical license number.
2. Step 2: Open the form and locate section 1, which is specifically designated for the physician's information.
3. Step 3: Begin by entering the physician's full name in the provided space.
4. Step 4: Fill in the contact details of the physician, which may include their phone number, email address, and office address.
5. Step 5: Next, input the medical license number of the physician.
6. Step 6: Review the filled-out information in section 1 to ensure accuracy and completeness.
7. Step 7: Once verified, proceed to the next section of the form and continue filling it out as necessary.

Who needs section 1 - physician?

1. Section 1 - physician is required to be filled out by individuals or organizations who are submitting a medical document or form that requires the involvement or endorsement of a specific physician.
2. For example, patients filling out a medical history form may need to provide the details of the physician who has been or is currently treating them.
3. Healthcare facilities and institutions may also require section 1 to be completed when submitting medical reports or documentation that involves the participation of a particular physician.

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