Here's how it works
01. Edit your certification of chronically ill individual online
Type text, add images, blackout confidential details, add comments, highlights and more.
02. Sign it in a few clicks
Draw your signature, type it, upload its image, or use your mobile device as a signature pad.
03. Share your form with others
Send chronically ill individual via email, link, or fax. You can also download it, export it or print it out.
How to use or fill out certification chronically with our platform
- Click ‘Get Form’ to open the certification chronically document in the editor.
- Begin by entering the patient’s name in the designated field at the top of the form.
- In section 1, check at least two activities of daily living (ADLs) that the patient is unable to perform without substantial assistance. Options include eating, bathing, toileting, dressing, transferring, and continence.
- Proceed to section 2 if applicable. Check both boxes indicating that there is clinical evidence and standardized tests measuring cognitive impairment.
- Select your professional designation by checking one of the options: physician, registered nurse, or licensed social worker.
- Finally, sign and print your name, date the document, and provide your address in the respective fields.
Start using our platform today for free to streamline your document editing and signing process!
Fill out certification chronically online
It's free
It's free
Security and compliance
At DocHub, your data security is our priority. We follow HIPAA, SOC2, GDPR, and other standards, so you can work on your documents with confidence.
Learn more
