A Disability Extension form is a document which enables a patient to draw benefits from the state or from the workplace like extended leave, financial assistance etc. A patient who has a physical or mental disability may apply for such an extension.
The Disability extension form includes full details of the patient’s medical condition which is compiled by a trained medical officer. The form should be prepared in such a way so as to include all necessary details required for granting disability extension. Below is a sample of Disability Extension form.
The sample Disability Extension template is available online in Microsoft Word and Editable PDF formats.
Disability Extension Form
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