Get Pennsylvania State University Verification Form For Deaf And Hard Of Hearing Impairments 2018-2025

Navigating the Pennsylvania State University Verification Form for Deaf and Hard of Hearing Impairments can be a crucial step in securing necessary accommodations. This guide provides clear, step-by-step instructions to help users effortlessly complete the form online.

Follow the steps to fill out the verification form effectively.

1. Press the ‘Get Form’ button to access the form and open it in your chosen document editor.
2. Begin by filling out the Student Information section. Enter the student's name, date of birth, Penn State campus, home address, phone number, and PSU ID number, ensuring all information is accurate and legible.
3. Proceed to the Provider Section. The provider should complete details regarding their contact with the student, including the date of initial and last contact, and the frequency of appointments.
4. In the Diagnosis section, the provider must specify the student's diagnosis, the date of diagnosis, and the severity of the impairment. Provide explanations as needed for each selection.
5. Indicate the expected duration of the impairment by selecting the appropriate option and detailing the duration checked.
6. Next, describe the student's current symptoms and attach a copy of the most recent audiogram if necessary. This includes detailing any anticipated progression of hearing loss.
7. Document any relevant historical information in the Student's History section, including developmental or medical backgrounds related to the hearing impairment.
8. In the Assistive or Adaptive Technology section, outline any aids or devices prescribed to assist the student, include their specifications, and state the preferred method of accessing in-class lectures.
9. Complete the Functional Limitations and Recommended Accommodations section. List current symptoms and suggest reasonable accommodations that could assist the student.
10. Finally, the provider must fill in their credentials in the Provider’s Certifying Professional Information section, provide their signature, and indicate if the completed form can be released to the student.
11. Once all sections are complete, save any changes made to the form. Users can then download, print, or share the completed form as needed.

Complete your documents online for a smoother process.