Download Disability Certificate Application Form- PDF

PDF NameDisability Certificate Application Form
DescriptionBased on your current knowledge and information provided by the applicant, please provide a response to each Benefit/Applicant Category.

After your health practitioner has explained your accident-related injury to you, sign. Your health practitioner will complete the rest of the form, based on his/her most recent assessment, and return it to the insurance company.

Only an authorized health practitioner can complete this form. The health practitioner’s opinion will be relied upon by people who review the certificate to make important decisions.

Accordingly, it is necessary to be accurate and complete. Please print clearly and provide all information requested. This form may not be materially altered. 

No. of Pages03
PDF Size945 KB
PDF LanguageEnglish
Published18th Aug 2020
TagsDisability Application Form,

Unique Disability ID Form- UDID,

PWD Disability Application Form PDF,

Download Disability Certificate Application Form – PDF


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