In Germany, if the dermatologist has definite proof that a patient's skin disorder is severe or chronic, work-related and requiring a change in occupation, then he or she must issue a Berufskrankheitenanzeige (loosely translated as occupational disease notification). The patient's consent is not required for this mandatory form, which has to be submitted even if the patient is opposed. On the other hand, if there is only a possible connection between the occupation and the skin disorder, or if the skin disease is neither severe nor chronic nor threatening pursuit of the occupation, then the dermatologist needs only write a Hautarztbericht (dermatologist's report). The patient's permission is required for this less formal document.