Get School Board Of Broward Medical Evaluation Form For Physically Impaired 2009-2025

Filling out the School Board of Broward Medical Evaluation Form for Physically Impaired online is an essential process to ensure that students with physical impairments receive the appropriate support. This guide will walk you through each section of the form, providing clear instructions to help you complete it accurately and efficiently.

Follow the steps to successfully complete the form online.

1. Click the ‘Get Form’ button to obtain the form and open it in the editor, allowing you to fill in the necessary information.
2. Begin by entering the student’s name in the designated field. Ensure the spelling is correct as it will be used for official records.
3. Next, input the student’s birthdate in the appropriate section. This will help verify the student's age and eligibility.
4. Provide the name of the parent or guardian, ensuring to include any relevant contact details so the school can reach them if necessary.
5. Complete the address section accurately. This information is important for correspondence regarding the student's evaluation.
6. Fill in the phone number field to ensure that the school can contact the family for any follow-up regarding the medical evaluation.
7. In the physician's section, check the appropriate description of the condition that applies to the student’s impairment. Choose one of the options provided.
8. Clearly describe the condition checked above in the indicated area. This should include any specific details needed for the assessment.
9. Input the date of onset of the condition. This helps in assessing the student's needs over time and identifying necessary accommodations.
10. Indicate whether the condition is stable, progressive, chronic, or acute by checking one of the provided boxes.
11. Describe any medical implications for instruction, such as medication or possible side effects. Include any future surgery or school activity limitations.
12. If required, attach separate prescriptions for physical or occupational therapy evaluations to support the student's needs.
13. Have the physician sign the form, ensuring to print their name and include their address and phone number for verification.
14. Fill in the section designated for the school’s use, including the date of referral and the person completing the form.
15. Complete the student’s enrollment status and any additional information regarding their learning and behavior needs.
16. Finally, review the entire form for accuracy, save your changes, and ensure that you have the option to download, print, or share the completed document for submission.

Start filling out the School Board of Broward Medical Evaluation Form for Physically Impaired online today to ensure comprehensive support for your student.