The West Virginia Physician Statement of Physical Capabilities is a form issued by the West Virginia Board of Medicine that allows a physician to provide a patient with a written statement detailing the patient’s physical capabilities. The form is used to document the physician’s opinion of the patient’s physical abilities and limitations, and is often required for certain types of employment or insurance applications. There are two types of West Virginia Physician Statement of Physical Capabilities: a standard form and an expanded form. The standard form includes the physician’s signature, date of issuance, the patient’s name, and the physician’s opinion as to the patient’s physical capabilities. The expanded form includes additional information such as the patient’s medical history, the physician’s diagnosis, and any additional comments or restrictions. Both forms require the patient’s signature in order to be valid.
West Virginia Physician Statement of Physical Capabilities
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