Medical opinion form hennepin county 2025

1. Click ‘Get Form’ to open the medical opinion form in the editor.
2. Begin by entering the date and case number at the top of the form. This information is crucial for tracking your request.
3. Fill in the medical provider's details, including name, clinic, address, and zip code. Ensure accuracy to avoid delays.
4. Next, provide your personal information: name, address, birth date, and Social Security number. This section is essential for identifying you as a client.
5. Sign the 'Authorization for Release of Information' section. This consent allows your medical provider to share necessary information with the agency.
6. On the back of the form, your medical provider will need to answer specific questions regarding your diagnosis and treatment plan. Make sure they complete this section thoroughly.
7. Once completed, return the form to the designated agency listed at the top. You can easily download or print it directly from our platform.

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