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Attending Physician Statement Complete and sign the form using BLUE or BLACK ink. Aetna Life Insurance Company PO Box 14560 Lexington, KY 405124560The Genetic Information Nondiscrimination Act of

How to fill out attending physician statement

How to fill out attending physician statement

1. Begin by gathering all necessary documents, such as the attending physician statement form and the patient's medical records.
2. Review the attending physician statement form carefully to understand the information required.
3. Fill out the general information section of the form, which typically includes the patient's name, date of birth, and contact information.
4. Provide detailed information about the patient's medical history, including any previous illnesses, surgeries, or hospitalizations.
5. Clearly indicate the current diagnosis and treatment plan for the patient, including any prescribed medications and recommended therapies.
6. Include information about the patient's functional abilities and limitations, such as their mobility or ability to perform daily activities.
7. If applicable, include any information regarding the prognosis or expected outcome of the patient's condition.
8. Sign and date the attending physician statement form, ensuring that all information provided is accurate and complete.
9. Submit the filled-out form along with any supporting medical records to the appropriate recipient.

Who needs attending physician statement?

1. The attending physician statement is typically required for various insurance purposes, such as life insurance or disability insurance.
2. It may also be needed by government agencies or legal entities for determining benefits or eligibility for assistance programs.

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What is attending physician statement?

The attending physician statement is a document completed by a patient's primary physician that provides information about the patient's medical condition and treatment.

Who is required to file attending physician statement?

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

How to fill out attending physician statement?

The attending physician statement can be filled out by the physician using the patient's medical records and treatment notes.

What is the purpose of attending physician statement?

The purpose of the attending physician statement is to provide accurate and up-to-date information about the patient's medical condition for insurance or legal purposes.

What information must be reported on attending physician statement?

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