Get Verification Of Disability Form For Asthma And Allergy ... - Health - Health Columbia

Completing the Verification of Disability Form for Asthma and Allergy is an essential step for students seeking accommodations at Columbia University. This guide provides clear, step-by-step instructions designed to help users navigate the form accurately and effectively.

Follow the steps to complete the form accurately and effectively.

1. Click ‘Get Form’ button to access the document and open it in the appropriate editor.
2. Enter the student’s name in the designated field at the top of the form. Make sure the spelling is correct as this information is crucial for verification.
3. Specify the diagnosis of the student in the next field, ensuring that it accurately reflects the condition of asthma or allergies as mentioned.
4. Provide the date of diagnosis to give context for the accommodations being requested.
5. Record the date of the last visit for this condition, which helps establish the ongoing management of the student's health.
6. Describe the procedures or assessments used for the diagnosis in the following section. Attach any relevant test results, such as allergy testing or pulmonary function testing.
7. Indicate the severity of the condition by circling one of the options: Mild, Moderate, Severe, or In Remission.
8. Answer whether the student has been treated in an emergency room or hospital for this condition within the last year by selecting Yes or No.
9. If applicable, provide the total number of hospitalizations related to this condition and the date of the last hospitalization.
10. List any environmental factors that exacerbate the student's condition, such as pollen, dust, or specific chemicals.
11. Indicate if the student takes prescription medication for this condition by selecting Yes or No. If Yes, fill in the details of medications, including dosage and frequency.
12. State whether the student uses a prescribed inhaler regularly and specify the frequency of use.
13. Detail any functional limitations that the student experiences due to this condition or its treatment, providing as much information as possible.
14. Make recommendations for accommodations that are clearly linked to the functional limitations described.
15. Estimate the anticipated duration of the need for accommodations based on the student's condition.
16. Complete the medical professional's section by including their name, license number, state, address, and telephone number.
17. Finally, ensure the medical professional signs the form, verifying they are not related to the student by blood or marriage, and provide the date.
18. Review all the entered information for accuracy and completeness. Users can then save changes, download, print, or share the form as needed.

Take action today by completing your Verification of Disability Form online to ensure the necessary accommodations are in place.