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Identify source statement 2026
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- Click ‘Get Form’ to open the identify source statement in the editor.
- Begin by entering the individual's name and social security number in the designated fields at the top of the form.
- Carefully read the instructions provided, which outline how to assess the individual's ability to perform work-related activities on a sustained basis.
- For each activity listed, indicate the level of limitation by checking the appropriate box (None, Mild, Moderate, Marked, Extreme) based on your professional opinion.
- In the sections that ask for supporting factors for your assessment, provide detailed explanations that justify your ratings.
- Complete any additional questions regarding past limitations and whether substance abuse affects current capabilities.
- Finally, sign and date the form, ensuring that your name, title, and medical specialty are printed legibly.
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