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How to fill out the Adhd Verification Form online
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.
- Click ‘Get Form’ button to obtain the form and open it in your preferred editor.
- 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.
- 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.
- 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.
- The healthcare provider should provide recommendations for accommodations, adaptive devices, assistive services, and any other relevant supports in the specified section.
- Ensure that the healthcare provider signs and dates the form, providing their name, title, license or certification number, address, and contact information as required.
- 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.
The ADHD diagnosis should be made by someone with appropriate professional credentials, should be specific, and should reference the Diagnostic and Statistical Manual of Mental Disorders (DSM-5 or whichever edition was current at the time of diagnosis).
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Assessments should include evidence of ADHD from several tests rather than just one test. Please note that this form will assist Disability Services in determining a student's eligibility for temporary registration and accommodations only. To the certifying professional: Please complete the form below in as much detail as possible. Please be aware that information which is incomplete or illegible may require additional follow-up from the ASO. The student named below is requesting reasonable and appropriate accommodations for Attention Deficit. Hyperactivity Disorder (ADHD). In compliance with the requirements set forth, this form is to verify that a disability exists and accompanying the disability are functional limitations. TESTING ACCOMMODATION - VERIFICATION FORM. This form may be released to the student at their request. 9) Unspecified ADHD: Symptoms characteristic of ADHD cause significant impairment in social, occupational, or other areas of functioning are present but do not.
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