2019 OH OPERS DR-APS-2025

1. Click ‘Get Form’ to open the 2019 OH OPERS DR-APS in our platform.
2. Begin by filling out the Member’s Personal Information section. Enter your Social Security Number, OPERS ID, name, date of birth, gender, and contact details including phone numbers and email address.
3. Proceed to the Member’s Authorization and Acknowledgment section. Carefully read the HIPAA disclosure and provide your signature along with today's date.
4. Next, complete the Attending Physician Information section. This must be filled out by your attending physician, including their name, specialty, contact information, and office hours.
5. In the Patient Information section, your physician will need to document treatment dates and frequency of visits for disabling conditions.
6. Finally, in the Physician Findings section, ensure that your physician provides detailed information about member complaints, symptoms, medications, and any relevant test results.

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