Get Wesleyan University Verification Of Disability Form For Asthma And Allergy Conditions 2018-2025

Completing the Wesleyan University Verification Of Disability Form for asthma and allergy conditions is an essential step for students seeking accommodations. This guide provides a clear and supportive approach to ensure that the form is filled out accurately and efficiently.

Follow the steps to fill out the form online.

1. Press the ‘Get Form’ button to access the form and open it in an editable format.
2. Begin by entering the student’s name in the designated field at the top of the form. Ensure the name is spelled correctly to match official records.
3. In the next section, input the date of the last visit related to the student's asthma or allergy condition. This information is crucial for verifying the current status.
4. Provide the official diagnosis of the condition. Include the date of diagnosis to help contextualize the student’s needs.
5. List any procedures or assessments used to diagnose the student. Be sure to attach any relevant test results, such as allergy or pulmonary function tests.
6. Choose the severity of the condition by checking one of the provided options: Mild, Moderate, Substantial, or In Remission.
7. Indicate whether the student has been treated in a hospital or emergency room for this condition in the past year by selecting 'Yes' or 'No.' If 'Yes,' provide the total number of hospitalizations and the date of the last hospitalization.
8. Describe any environmental factors that worsen the condition by providing a detailed explanation.
9. If the student takes prescription medication for their condition, specify the medication name and dosage in the areas provided.
10. Indicate if the student uses a prescribed inhaler regularly and specify the frequency of use.
11. Define any functional limitations caused by the condition or its treatment. Be thorough and clear to assist in the accommodation process.
12. List any recommended accommodations that are directly linked to the identified functional limitations.
13. Finally, estimate the anticipated duration for which accommodations will be needed.
14. Complete the signature section with the medical professional’s name, title, license number, state of license, contact information, and signature, confirming they are not related to the student.
15. Review the completed form for accuracy and consistency, then save changes. Options to download, print, or share the form will be available.

Complete your forms online today to ensure timely processing of requests for accommodations.