Principal Life uses the GP53792 Attending Physician's Statement as the doctor's part of a group disability claim for sickness, injury, pregnancy or a mental health condition. Rather than a printable PDF, it is an online form: the employee shares the link or the doctor opens it from Principal's forms page, completes and e-signs it in Adobe Acrobat Sign, and can attach office notes.
The attending physician completes the whole four-page statement. The employee and employer file their own parts through Principal's online disability claim, which they sign in to submit.
Download the current version from the source each time; forms change without notice.
Attending Physicians Statement
This form is completed online with Principal Life Insurance Company (Principal Financial Group), so there is no PDF to fill. Vero Scribe writes the visit note it draws on, so the details are ready when you complete it.
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Principal links the statement as an Adobe Acrobat Sign web form rather than a static PDF. The doctor completes and signs it online, and a PDF copy can be downloaded from the signing page after completion. Office notes can be attached in the same session.
Principal's business forms page says the employee can provide the doctor with the Attending Physician's Statement, which opens in Adobe Sign, or the doctor can submit the claim online. The employer and employee sign in and submit their parts of the online disability claim separately.
It supports group disability claims for sickness, injury, pregnancy or mental health conditions, the same categories Principal lists for its online employee and employer disability claim. Accident and critical illness claims use separate physician statements.