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DHS-2114-ENG (MDHS Request for Medical Opinion)

DHS-2114-ENG (MDHS Request for Medical Opinion)-2025

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The document is a Request for Medical Opinion form from the Minnesota Department of Human Services, used to gather medical information about a client to determine eligibility for public assistance programs. It includes sections for client details, authorization for release of information, and specific questions for medical providers regarding the client's health status and limitations. The form emphasizes the importance of obtaining medical facts to facilitate access to necessary services.

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What is a medical opinion?

Medical opinions are statements from acceptable medical sources that reflect judgments about the nature and severity of your impairment(s), including your symptoms, diagnosis and prognosis, what you can still do despite impairment(s), and your physical or mental restrictions.

What is a medical opinion form for?

A medical opinion form is used by medical practitioners to collect personal information, medical history, or medical details from patients. With a free online medical opinion form, you can collect the right information from patients right at the point of care!

What is a medical release form used for?

Medical opinion evidence refers to statements or reports from qualified healthcare providers that offer an expert assessment of your medical condition. These opinions typically address key aspects of your illness or injury, such as diagnosis, prognosis, and functional limitations.

What does medical opinion mean?

Who can fill out this form? Healthcare providers, social workers, or family members can complete this form based on their knowledge of the patients situation.