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Description of functional capacity form
Functional Capacity Certificate Form 507 FCC507 NOTE TO BE COMPLETED BY SERVICE MEMBER PLEASE READ QUESTIONS CAREFULLY Answer All Questions by placing an X in the appropriate block. If No Current Physical Limitations indicate None. 2. Physician s Statement I have reviewed this Service Member s Functional Capacity Certificate FCC507 and Circle One CONCUR / DO-NOT-CONCUR with Service Member s Self Assessment....
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