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Physician's Statement of Health
Physician's Statement of Health

Blank Physician's Statement of Health Form and how to submit in-app.

Lara Freiberger avatar
Written by Lara Freiberger
Updated over a week ago

A statement of health from your physician is a document that clearly states that you are in good physical and mental health and free of any communicable diseases. This is required if you are in the states of Wisconsin or Pennsylvania.


How to Get a Physician's Statement

If you have already had a physical in the last year, you can call your doctor’s office and request they fill out this form. Otherwise, you can bring this form with you when you complete your annual physical.

This form is supplemental to your annual physical and is not considered a replacement.

If you need assistance finding a clinic near you, check out our Getting a Physical, TB Test, or Immunization article!


Submitting Your Physician Statement

To submit your Physician Statement, follow these steps:

If you are in the State of Wisconsin

  1. Go to My Credentials and tap Physician Statement located under Required.


  2. Tap Next


  3. Take a photo or select from gallery


  4. Tap Save and Submit

If you are in the State of Pennsylvania

  1. Go to My Credentials and tap Physician Statement located under Additional.


  2. Tap Next


  3. Take a photo or select from gallery


  4. Tap Save and Submit


Questions?

If you have a question about your Physician Statement, please start a chat with us in the ShiftMed app by selecting Menu > Help Center > Help Article & Chat > Messages > Send us a Message.

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