Forms Package

We can’t impress upon you enough the value of using the forms to accompany your file and serve as exhibits in cases involving litigation as accident cases. 

It is VITAL to meet court “Evidentiary Burdens of Proof” showing evidence- based data to establish the preponderance, beyond a reasonable doubt. The evidence must be more than a “MERE SCINTILLA”. It is up to you, the physician to show that one side has more believability than the other and produce the presumptive “greater weight” of the evidence.

These forms should be part of your records to establish the veracity of your patients'; DUD's, LOE's, ADL's, symptoms and complaints. If your patient has any positive findings in either DUD, LOE or ADL – it represents that the patient themselves has imposed restrictions upon themselves. You must write a medically prescribed restriction to match the patient’s DUD, LOE and ADL admission of restriction. Use the form entitled:  Form For Medically Prescribed Restrictions.

Likewise, if your patient’s symptoms are excessive, you will need supportive statements from witnesses and should use the form entitled: Witness Statement of Support


Forms include: 

  • Form for Medically Prescribed Restrictions 
  • Witness Statement of Support
  • Provider Request For Evaluation and Continued Care
  • Post-Traumatic Stress Disorder Questionnaire
  • Cervical Sympathetic Syndrome Questionnaire

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This product was added to our catalog on Wednesday 22 February, 2017.

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