Bundle
English
Visible
Visible
Type
Sub-App
Environment
Description
PHYSSTAT - Physician's Statement/Letter
bulk_update
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Message
<p><strong>Physician or Medical Provider's Statement or Letter</strong></p> <p>Please make sure your document includes:</p> <ul> <li>Your name.</li> <li>Your home address listed on your application.</li> <li>The name of your medical provider.</li> <li>The phone number of the service provider.</li> <li>The date of the medical injury or illness.</li> <li>A brief description of the medical loss or injury you had at the time of the disaster.</li> </ul>