Form LB-1109 Physician Certification Form - Tennessee

Form LB-1109 Physician Certification Form - Tennessee

What Is Form LB-1109?

This is a legal form that was released by the Tennessee Department of Labor and Workforce Development - a government authority operating within Tennessee. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the Form LB-1109 Physician Certification Form?
A: The Form LB-1109 Physician Certification Form is a document used in Tennessee to certify a person's medical condition and need for disability parking placards.

Q: Who needs to fill out the Form LB-1109 Physician Certification Form?
A: The Form LB-1109 Physician Certification Form needs to be filled out by a licensed physician or other authorized healthcare professional.

Q: What is the purpose of the Form LB-1109 Physician Certification Form?
A: The purpose of the Form LB-1109 Physician Certification Form is to validate an individual's eligibility for disability parking placards in Tennessee.

Q: What information is required on the Form LB-1109 Physician Certification Form?
A: The Form LB-1109 Physician Certification Form requires information such as the individual's name, medical condition, and the physician's contact information.

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Form Details:

  • Released on November 1, 2015;
  • The latest edition provided by the Tennessee Department of Labor and Workforce Development;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form LB-1109 by clicking the link below or browse more documents and templates provided by the Tennessee Department of Labor and Workforce Development.

Download Form LB-1109 Physician Certification Form - Tennessee

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  • Form LB-1109 Physician Certification Form - Tennessee, Page 1
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