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HAND AND FINGER CONDITIONS. DISABILITY BENEFITS QUESTIONNAIRE ... SUPERSEDES VA FORM 21-0960M-7, OCT 2012, ...... FAX Numbers can be found at www.vba.va.gov/disabilityexams or obtained by calling
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How to fill out a note to your physician:

01
Start by addressing the note to your physician. Include their name and title, such as "Dear Dr. Smith" or "To my primary care physician."
02
Begin the note with a polite greeting, such as "I hope this message finds you well" or "I hope you are doing great."
03
Clearly state the purpose of the note. Explain why you are reaching out to your physician, whether it is to seek medical advice, report a health concern, or request a refill for a prescription.
04
Provide a detailed description of your symptoms or concerns. Be specific and include any relevant information such as the duration of symptoms, intensity, and any triggering factors.
05
If necessary, mention any medications you are currently taking or any recent changes in your medical history that might be relevant to your condition.
06
Ask any specific questions you may have for your physician. Be concise and prioritize the most important questions or concerns.
07
Thank your physician for their time and consideration. Express your appreciation for their expertise and guidance.
08
Close the note with a polite farewell, such as "Thank you for your attention to this matter" or "I look forward to hearing from you soon."
09
Sign the note with your name and contact information, including your phone number and email address if applicable.

Who needs a note to your physician:

01
Patients seeking medical advice or guidance regarding their health condition.
02
Individuals experiencing new or concerning symptoms.
03
Patients who require prescription refills or medication adjustments.
04
People with chronic illnesses who need to update their physician on their progress or seek further medical intervention.
05
Individuals who have questions or concerns about their current treatment plan.
06
Patients with upcoming appointments who may need to discuss specific matters with their physician in advance.

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Note to physician is a document that provides important medical information about a patient to their healthcare provider.
Note to physician is typically filled out by the patient or their legal guardian.
Note to physician can be filled out by providing accurate and detailed information about the patient's medical history, current medications, allergies, and any other relevant health information.
The purpose of note to physician is to ensure that healthcare providers have access to important medical information that can help them provide appropriate care to the patient.
Information that should be reported on note to physician includes medical history, current medications, allergies, any ongoing treatments or therapies, and emergency contact information.
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