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How to complete the Medical Professional Information section
Contact Information
Fill out the professional information for the medical professional or certifying agent that is verifying the consumer’s disability.
Cargar documentos justificativos
This section is optional. If you have supporting documentation to verify a consumer’s disability you may upload it here. The documentation must meet the following criteria:
You can upload the following types of files:
- Doc
- Docx
Files must be 1 MB or less.
To find the size and format of your file you can:
- Windows:
- Right-click the file
- Select "Properties"
- A window will open showing information about your file
- Mac
- Select the file
- Press Command + i on your keyboard
- A window will open showing information about your file
Your application will be considered complete without filling out the Medical Professional Information if you can upload one of the following:
- Prescription
- Reports including:
- Audiogram
- Vision Exam
- Health Certificate
- Signed note or letter from a Medical Professional
Your supporting documentation needs to be dated within the last two years and include the Medical Professional’s:
- Full Name
- Telephone Number
- State license number (if applicable)
The document must also clearly indicate the applicant's disability.
Do not include any documents that list your client's:
- Social security number
- Banking information
- Credit card number
- Identification number
Firma del profesional
Click the signature box and draw your signature.




