Medical Assessment Form



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How to create a Medical Assessment Form? Download this Medical Assessment Form template that will perfectly suit your needs.

The Medical Assessment Form objective is to ensure that people claiming for injuries sustained in an accident have their compensation assessed quickly and fairly, without unnecessary litigation overheads. 

Our collection of online health templates aims to make life easier for you. Our site is updated every day with new health and healthcare templates. By providing you this health Medical Assessment Form template, we hope you can save precious time, cost and effort and it will help you to reach the next level of success in your life, studies or work!

Medical Assessment Form
The Claimant must submit a report from their treating Practitioner for us to
assess their claim. Please note a copy of the medical report will be passed to the Respondent/s (the person/s against whom the claim is being made) and their insurers where known, in order that they may know the nature and extent of the claim. As a result the medical report should only contain medical history relevant to the claim being made.
We have undertaken to have the majority of claims assessed within nine months of submission and with this time frame in mind, it is vital that your report adheres to the following guidelines: clear, concise and gives, as far as is possible, a final prognosis and likely recovery period. 

Reports should 
  • Be submitted in a standard format as per the attached template
  • Be as clear and concise as possible
  • Contain an Opinion/Prognosis and your view on the likely recovery time for the Claimant’s injuries to resolve. If a full recovery is unlikely, outline the residual symptoms likely to be suffered by the Claimant and what effect these will have on their lifestyle/work
  • Include relevant details of the Claimant’s medical and accident history and advise whether the accident has exacerbated any pre-existing symptoms/injury Where a final prognosis is not currently available we will arrange an up to date examination of the claimant.
  • If the claim proceeds to assessment, the Claimant will be awarded the reasonable and necessary cost of this medical report. Failure to furnish an adequate report may result, in exceptional cases, in this amount not being awarded.

This Medical Assessment Form is intuitive, ready-to-use and structured in a smart way. Try it now and let this Medical Assessment Form sample inspire you.

We certainly encourage you to download this Medical Assessment Form now and use it to your advantage!


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Nothing on this site shall be considered legal advice and no attorney-client relationship is established.


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