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pdf1st Party
Section 1: Information about the Disabled Person
Section 2-Contacts
Section 3: Medical Conditions
Section 4: Work Activity
If yes,
Section 5 : Education and Training
Section 6: Work History
If yes,
Section 7: Medicines
Section 8: Medical Treatment
Tests
Doctors and Other Healthcare Professionals
Hospitals and Clinics
Section 8: Other Medical Information
3rd Party
Section 1: Information about the Disabled Person
Section 2: Contacts
Section 3: Medical Conditions
Section 4: Work Activity:
Section 5: Education and Training
Section 5: Education and Training
Section 6: Job History
If yes,
Job Details continued
Section 7: Medicines
Section 8: Medical Treatment
Test Details
Doctor and Other Healthcare Professionals
Hospitals and Clinics
Section 9: Other Medical Information
File Type | application/pdf |
File Title | Microsoft Word - i3368 Screenshots 1st and 3rd parties.docx |
Author | 657290 |
File Modified | 2023-10-02 |
File Created | 2021-04-15 |