Instructions for Submitting Your Form
Instructions
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This site is for patients or their caregivers who need a Disability Form completed to apply for disability benefits or employer leave.
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ONLY ONE FORM is permitted per request.
For EACH type of form you need completed by the clinic, you MUST upload one form only, pay for it, and submit it online.
If you have more than one form to be processed then you will need to submit and pay for each form separately.
Three forms - then 3 separate independent online submissions.
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IF YOU UPLOAD MORE THAN ONE FORM PER ONLINE SUBMISSION THEN YOUR FORM SUBMISSION WILL BE REJECTED.
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You may choose to have your form processed within 2 business days (rush request) or in 7-15 business days.
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Pre-payment is required before your Disability Form can be processed.
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No refunds will be given unless the Disability Form cannot be completed.
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The processing time begins once we have received all necessary items: prepayment, a completed request/authorization, and the Disability Form.
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Once completed, your Disability Form will be made available online for you to save, print, or email as needed.
You may also ask for your Disability Form to be faxed/emailed directly to a third party (such as an insurance company or employer)
and/or you may pick up a copy of your form in our office.
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You will need the following:
- A valid driver's license or other valid state-issued ID.
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A picture or PDF of your filled-out form ready to be uploaded
- A credit/debit card to make payment
- (Optional) The contact information of the recipient, if you want your completed form sent to a third party (e.g. an employer or insurance company).
Please have these items handy before you start!
To keep you up-to-date, you will receive two text alerts - one to confirm that your request is in process and one to let you know that your request is complete.
You will receive text messages similar to these samples:
TEXT MESSAGE EXAMPLE:
Dallas Orthopedic and Shoulder Institute is reviewing your request.
Will message if any issues.
Will message again when form is ready.
Tracking #XXXX-XXXX
TEXT MESSAGE EXAMPLE:
Your Disability/FMLA form is ready.
Go to https://drequest.trimsnet.net/patient/landing/dosiup.
Click green box.
Tracking #XXXX-XXXX
There has been an error processing your request.
Technical support has been alerted, however additional information will help solve this issue.
Please send some brief comments describing what you were doing: