Get Hearing Disability Verification Form - Csuohio

Filling out the Hearing Disability Verification Form is an essential process for students seeking academic accommodations due to hearing disabilities. This guide provides step-by-step instructions to ensure a smooth and comprehensive completion of the form online.

Follow the steps to effectively complete the Hearing Disability Verification Form online.

1. Press the ‘Get Form’ button to download the Hearing Disability Verification Form and open it for editing.
2. Begin with the student information section. Fill in the first name, middle name, last name, date of birth, and the last four digits of the Social Security Number. Provide both local and cell phone numbers along with the complete mailing address.
3. Proceed to the diagnostic information section. Specify the degree of hearing loss by indicating whether it is mild, moderate, severe, or profound. Attach a recent audiogram and note when the diagnosis was made as well as the last contact date with the student.
4. Indicate whether the hearing loss is expected to remain stable or decline. If it is expected to decline, provide a brief description of the anticipated progression.
5. Describe how the hearing disability may impact the student academically and/or physically, including any functional limitations they may experience.
6. Discuss the means of communication this student has previously used. Provide details on their proficiency in those communication skills.
7. Outline any recommended accommodations or auxiliary aids that may assist the student in an academic setting, such as interpreters or note-takers, and explain the rationale behind these recommendations.
8. If there are any associated disabilities, be sure to describe them in detail.
9. Complete the healthcare provider information section. The provider must sign and date the form and include their name, title, license number, contact information, and fax number.
10. After completing all sections of the form, save your changes, and prepare to print, download, or share the finalized document.

Complete your Hearing Disability Verification Form online today for timely academic accommodations.