098 Baker Hall 2026

1. Click ‘Get Form’ to open the Disability Verification Form in the editor.
2. Begin by filling out the 'STUDENT INFORMATION' section. Enter the student's first name, middle name, last name, date of birth, and local phone number. Ensure all information is printed legibly or typed.
3. Indicate the student's status by checking one of the options: current student, transfer student, or prospective student. Also, provide a cell phone number and email address if applicable.
4. Move to the 'DIAGNOSTIC INFORMATION' section. Fill in the date of diagnosis and primary diagnosis. If there are other diagnoses, list them as well.
5. Assess and select the severity of the disorder from mild, moderate, or severe. Then detail any medications or treatments prescribed to the student.
6. Describe how the disability symptoms impact academic performance and provide specific recommendations for academic accommodations.
7. In the 'HEALTHCARE PROVIDER INFORMATION' section, sign and date the form. Fill in your name, title, license number, address, phone number, and fax number.

Start using our platform today to complete your forms online for free!