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Authorization for Release of Medical Information for. Americans with Disabilities Act ( ADA ) Reasonable Accommodations .

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How to use or fill out the ADA Form1511.docx online

Filling out the ADA Form1511.docx online is a straightforward process designed to assist individuals in requesting accommodations under the Americans with Disabilities Act. This guide will provide a clear, step-by-step approach to ensure that all required information is submitted accurately and efficiently.

Follow the steps to complete the ADA Form1511 online.

  1. Click the ‘Get Form’ button to obtain the form and open it in your preferred document editor.
  2. Begin by filling in your personal information. This includes your name, Penn Foster Student ID Number, current program, phone number, and email address.
  3. Specify the accommodation you are requesting in the designated area. If necessary, provide additional details on the back of the form.
  4. Describe the reason for the accommodation by outlining the condition or limitation you have. Again, you may continue on the back of the form for more information as needed.
  5. Complete the health care provider information section. Include the name, specialty, address, phone number, and fax number of your treating physician. It is essential to attach any supporting documentation from your physician, which should be on official letterhead and signed.
  6. Review the authorization statement provided in the form. By signing and dating, you authorize Penn Foster to obtain necessary medical information regarding your request.
  7. Ensure that all information is accurate and complete. Save your changes to the document.
  8. Download or print the filled-out form. You may also share it via email to the address provided, or fax it to the number listed.

Take the first step towards obtaining your accommodations by completing the ADA Form1511 online today.

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