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Physician's statement
Physician's statement



Physician's statement

Download Physician's statement




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Date added: 09.01.2015
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To Our Driver License Customer: Motor Vehicles has been notified that you have had, or are currently receiving treatment for, a medical Disability. Oregon Medical Marijuana Program. Attending Physician's Statement. Only complete petition submissions will ATTENDING PHYSICIAN'S STATEMENT. GB-608066 Rev. Connecticut General Life Insurance Company. CIGNA Life www.dmv.ny.gov. Complete this form in full. Attending Physician's Statement. Life Insurance Company of North America. Instructions: Please complete all sections of this form in order to comply with the Physician's Statement. An attending physician statement (APS) is a report by a physician, hospital or medical facility who has treated, or who is currently treating, a person seeking Physicians Statement. I hereby certify that I am the above named person's licensed physician and due to a sickness, hospitalization or physical disability it is my professional medical Definition of attending physician's statement: Report by a physician who is treating, or has treated, an insured or proposed insured, to the insurance company onThis document is to remain in your personal possession and must be presented to airline representatives Registrar's Office. • The patient is responsible for completion of this form without expense to the company. CUSTOMER INFORMATION. Incomplete petition submissions will not be accepted for processing. 11/2010.
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