Get Wesleyan University Verification Of Disability Form For Asthma And Allergy Conditions 2017

Completing the Wesleyan University Verification Of Disability Form For Asthma And Allergy Conditions is essential for students seeking reasonable accommodations. This guide provides clear, step-by-step instructions to assist you in accurately filling out the form online.

Follow the steps to complete the form efficiently.

1. Click the 'Get Form' button to access the document and open it in your editor.
2. Begin by entering the student's name and date in the designated fields. This information identifies the individual requiring accommodations.
3. Next, specify the diagnosis and date of diagnosis. Ensure that you provide precise details to facilitate accurate assessment.
4. Indicate the date of the last visit related to this condition. This shows the recency of treatment and ongoing management.
5. List the procedures or assessments used to diagnose the student’s condition. Attach copy of relevant test results, such as allergy tests or pulmonary function evaluations.
6. Select the severity of the condition by checking the appropriate box: Mild, Moderate, Substantial, or In Remission.
7. Respond to whether the student has been treated in an emergency room or hospital for this condition in the past year. Provide the total number of hospitalizations and the date of the last hospitalization, if applicable.
8. Describe environmental factors that exacerbate the condition, as this information assists in understanding the context of the disability.
9. If the student takes prescription medication, specify the medications, dosage, and frequency in the provided section.
10. Indicate if the student uses a prescribed inhaler regularly, including the frequency of use.
11. Discuss the functional limitations caused by the condition and its treatment. This information is critical for assessing accommodation needs.
12. Recommend specific accommodations that are clearly linked to the identified functional limitations, ensuring they are relevant and achievable.
13. Provide the anticipated duration of the need for accommodation based on the student’s current health status.
14. Fill out the medical professional's name, license number, phone number, and address. This verifies the authenticity of the information provided.
15. Finally, the medical professional must sign and date the form to validate the information while confirming they are not related to the student.
16. Once all fields are complete, save any changes you have made. You may also choose to download, print, or share the form as needed.

Ensure a smooth process by completing your document online now.