Form 6 - Attending Physician'S Report Page 2
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2FILING INSTRUCTIONS
(Instructions Updated 09/01/07)
Attending Physician’s Report
VWC Form 6
The treating physician completes this form and the report provides specific medical information
including date of accident, diagnosis, prognosis, the disability period(s), and the extent of any
permanent disability.
Forms: Additional copies of this form are available without cost by writing to the Commission.
Address your inquiry to “Forms” at the listed Virginia Workers’ Compensation Commission
address. The form is also available on the Commission’s Website, at
Please note that any alternate versions of the form you develop yourself require prior approval by
the Commission.
For questions or assistance with completing the form, please contact the Awards Unit using the
Commission’s Toll-free number (1-877) 664-2566 or visit our Website, at
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