Hello afrost: I see this is your first post here on PC. So... welcome to Psych Central. You didn't mention whether or not you've actually gone in to see your doctor with the form in hand. If not, I would think that would be the thing to do. Doctors are always busy. And if you're not sitting right there in front of them, this sort of thing can easily slip through the cracks, so to speak.
Of course it is also possible your doctor has some objection to signing the form. And if that's the case, sitting there in front of her / him would be the most efficient way of ferreting that out. If that should turn out to be the case, you may simply need to find another doctor.
I hope you find PC to be of benefit.