Get Medical Disability Documentation Form (pdf) - The University Of ... - Uta
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How to fill out the Medical Disability Documentation Form (PDF) - The University Of Texas at Arlington online
Completing the Medical Disability Documentation Form is an essential step for students seeking accommodations due to medical conditions. This guide provides a clear and structured approach to filling out the form accurately and efficiently.
Follow the steps to successfully complete the Medical Disability Documentation Form online.
- Press the ‘Get Form’ button to access the form and open it in your preferred PDF viewer.
- Fill in the date at the top of the form to indicate when the documentation is being submitted.
- Provide the full name of the student in the designated area to ensure proper identification.
- In the section addressed to the medical professional, confirm the patient's care status by answering whether the patient is currently under their care and for how long.
- Clearly state the diagnosis, impairment, or condition of the student, ensuring it aligns with the criteria needed for the disability services.
- Include the date the diagnosis was made to provide context for the condition's timeline.
- Indicate the last date the medical professional saw the patient to reflect the recency of the evaluation.
- Checkboxes under 'Major Life Activities Assessment' need to be filled out to indicate which major life activities are affected by the condition. State the level of limitation for each affected activity.
- Provide a detailed explanation of the specific functional limitations arising from the impairment and how they impact the student's ability to engage in a learning environment.
- Answer questions regarding the permanence of functional limitations and any anticipated resolution dates.
- List any medications the student is taking along with their effects and potential side effects.
- If applicable, describe any ongoing treatments the student is undergoing and their potential effects on academic performance.
- Once all sections are completed, the medical professional should sign and date the document, providing their printed name and license number.
- Finally, save the completed form, download it for your records, or print it out for submission as needed.
Complete your Medical Disability Documentation Form online to ensure timely access to the accommodations you need.
“Record of” means that the person has a history of, or has been misclassified as having, a mental or physical impairment that substantially limits one or more major life activities, even though the person does not currently have a disability.
Fill Medical Disability Documentation Form (PDF) - The University Of ... - Uta
Disability Documentation Form. Documentation may be faxed to . Documentation can be sent to the following address: The University of Texas at Austin Division of Student Affairs Documentation of surgery or scheduled medical procedures. Emergency room or urgent care visit records. A treating certified medical professional should complete this form or provide equivalent information on professional letterhead. Documentation of surgery or scheduled medical procedures. Emergency room or urgent care visit records. A treating certified medical professional should complete this form or provide equivalent information on professional letterhead. You must be a licensed healthcare professional to complete this form.
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