Get Adhd Verification Form

Completing the Adhd Verification Form online is an important step for students seeking academic accommodations due to attention-deficit/hyperactivity disorder. This guide provides clear instructions on how to accurately fill out each section of the form to ensure your documentation meets the necessary requirements.

Follow the steps to effectively complete the Adhd Verification Form.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred editor.
2. Fill in your personal information in the 'Student Information' section. This includes your full name, date of birth, status (current, transfer, or prospective student), BW ID number (if applicable), local and cell phone numbers, and email addresses. Ensure all information is printed legibly.
3. In the 'Diagnostic Information' section, your healthcare provider should complete the required items. They must provide the DSM-IV diagnosis, the methodology used to reach the diagnosis, the date of diagnosis, the severity level of the condition, and detailed patient history including ADHD history, psychosocial history, pharmacological history, and educational history.
4. Healthcare providers need to check current specific symptoms from the provided list that align with the DSM-IV criteria. This includes symptoms related to inattention, hyperactivity, and impulsivity.
5. The healthcare provider should provide recommendations for accommodations, adaptive devices, assistive services, and any other relevant supports in the specified section.
6. Ensure that the healthcare provider signs and dates the form, providing their name, title, license or certification number, address, and contact information as required.
7. Once the form is completed, save changes, download, print, or share the form as necessary.

Complete and submit your Adhd Verification Form online today to secure the academic services you need.