PRIVATE PHYSICIAN PROCESS FORMS

Updated: September 25, 2017


These Private Physician forms should only be used if you meet one of the following criteria:

  • You received specific direction from the VCF to complete the forms; or
  • You are filing a claim for a deceased individual who was not certified for treatment by the WTC Health Program for the claimed condition; or
  • You were previously deemed eligible for compensation from the VCF based on a certified condition, and you are now seeking to add a non-certified cancer as a claimed condition.

If you do not meet the criteria above, you should not complete the Private Physician forms.


You can review Frequently Asked Questions ("FAQs") specific to the Private Physician process in Section 7 of our FAQs.


Individual Forms:



WTC HEALTH PROGRAM GUIDANCE


The WTC Health Program has published the following materials related to the VCF Private Physician process. Claimants are strongly encouraged to review these materials before completing the Private Physician forms.


Click here to visit the WTC Health Program website.



IMPORTANT REMINDERS