How to use or fill out 4631 with our platform
- Click ‘Get Form’ to open it in the editor.
- Begin by filling in your personal information, including your name and Social Security Number. If applicable, provide the wage earner's details as well.
- In section B, answer whether you have been treated by a doctor since the last update. If yes, list the names, addresses, and phone numbers of these doctors along with the dates of treatment.
- Next, describe what these doctors have communicated regarding your condition in the provided space.
- Indicate if you have been hospitalized since the last update. If so, provide the hospital's name and address, along with reasons for hospitalization and treatments received.
- If additional space is needed for any section, feel free to use extra sheets as necessary.
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