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01. Edit your physician certification of terminal illness form online
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How to use or fill out certification terminal illness with our platform
- Click ‘Get Form’ to open the certification terminal illness document in the editor.
- In the 'Initial Certification Statement' section, enter the date range for certification. Fill in the patient's name and diagnosis, ensuring accuracy as this is crucial for medical records.
- For 'Verbal Certification from', input the attending physician's name and have them sign in the designated area. A staff member should also provide their signature and date.
- Repeat similar steps for the 'Re-Certification Statement', entering the new date range, patient details, and obtaining necessary signatures from both the physician and staff member.
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