PDF Name | Disability Certificate Application Form |
Description | Based 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 Pages | 03 |
PDF Size | 945 KB |
PDF Language | English |
Category | |
Published | 18th Aug 2020 |
Tags | Disability Application Form, Unique Disability ID Form- UDID, PWD Disability Application Form PDF, |