Pennsylvania Code
Title 231 - RULES OF CIVIL PROCEDURE
Part I - GENERAL
Chapter 1910 - ACTIONS FOR SUPPORT
Rule 1910.29 - Evidence in Support Matters
Current through Register Vol. 54, No. 38, September 21, 2024
(a) Record Hearing. Except as provided in this rule, the Pennsylvania Rules of Evidence shall be followed in all record hearings conducted in an action for support. A verified petition, affidavit or document, and any document incorporated by reference therein which would not be excluded under the hearsay rule if given in person shall be admitted into evidence if (1) at least 20 days' written notice of the intention to offer them into evidence was given to the adverse party accompanied by a copy of each document to be offered; (2) the other party does not object to their admission into evidence; and (3) the evidence is offered under oath by the party or witness. An objection must be in writing and served on the proponent of the document within 10 days of the date of service of the notice of intention to offer the evidence. When an objection is properly made, the Pennsylvania Rules of Evidence shall apply to determine the admissibility of the document into evidence.
(b) Medical Evidence.
IN THE COURT OF COMMON PLEAS
OF
____________
COUNTY
Member Name:
Docket Number:
PACSES Case Number:
Other State ID Number:
PHYSICIAN VERIFICATION FORM
TO BE COMPLETED BY THE TREATING PHYSICIAN
Physician's name: ______________________________________
Physician's license number: ______________________________________
Nature of patient's sickness or injury:
______________________________________
______________________________________
______________________________________
Date of first treatment: ______________________________________
Date of most recent treatment: ______________________________________
Frequency of treatments: ______________________________________
Medication: ______________________________________
The patient has had a medical condition that affects his or her ability to earn income from:
____________
through
____________
If the patient is unable to work, when should the patient be able to return to work? Will there be limitations?
______________________________________
______________________________________
Remarks:
______________________________________
______________________________________
Date:
____________
Signature of Treating Physician: ______________________________________
Physician's address:
______________________________________
______________________________________
______________________________________
Physician's telephone number: ______________________________________
I authorize my physician to release the above information to the
____________
County Domestic Relations Section.
Patient's signature:
____________
Date:
____________