Medical 504 form 2026

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The document is a Medical Review form for 504 accommodations for the 2016-2017 school year, intended to be completed by a student's health care practitioner. It includes sections for medical diagnosis, temporary conditions, requested accommodations, and specific health issues such as allergies, diabetes, and seizure disorders. The form aims to gather necessary information to support students with disabilities in their educational environment.

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Click ‘Get Form’ to open the medical 504 form in the editor.
Begin by entering the student's name, date of birth, school name, and student ID number in the designated fields at the top of the form.
In section one, select the appropriate medical diagnosis or disability from the provided options. If applicable, include ICD-10 or DSM-V codes.
Indicate whether the condition is temporary by checking 'Yes' or 'No' and specify the estimated duration if it is temporary.
Complete the accommodations table by listing requested accommodations for each diagnosis. Ensure to check relevant boxes for specific needs.
Provide details on how the diagnosis affects educational performance and list any necessary tasks for a paraprofessional if applicable.
Fill out health care practitioner information including name, contact details, and signature at the bottom of the form.

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Versions	Form popularity	Fillable & printable
2019	4.8 Satisfied (116 Votes)
2016	4.4 Satisfied (38 Votes)

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What diagnosis is needed for a 504?

Who is eligible for Section 504? Students may qualify for protection under Section 504 if they have a mental or physical impairment that substantially limits one or more major life activities. A label, disability, or diagnosis alone, does not make a student eligible under Section 504.

What is a 504 for medical reasons?

Thus, students with physical impairments, such as diabetes, asthma, allergies, or epilepsy, may be Section 504 eligible if their impairment substantially limits one or more major life activities or major bodily functions, even if the impairment does not limit learning.

What is medical code 504?

Section 504 forbids organizations and employers from excluding or denying individuals with disabilities an equal opportunity to receive program benefits and services. It defines the rights of individuals with disabilities to participate in, and have access to, program benefits and services.

Who is required to attend a 504 meeting in Texas?

Who Participates in the Evaluation Meeting? Section 504 requires a person knowledgeable about the student, a person knowledgeable about the meaning of the evaluations, and someone knowledgeable about placement options.

What are the three steps of the 504 process?

Section 504 requires that disabled students be provided with a free appropriate public education including education with non-disabled peers to the maximum extent appropriate. The Section 504 Process consists of four steps: (1) Referral; (2) Evaluation; (3) Eligibility Determination; and (4) the Section 504 Plan.

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What are the requirements for 504 in Texas?

To be protected under Section 504, a student must be determined to: (1) have a physical or mental impairment that substantially limits one or more major life activities; or (2) have a record of such an impairment; or (3) be regarded as having such an impairment.

What qualifies as a 504 disability in Texas?

Section 504 protects people with a physical or mental impairment that substantially limits a major life activity, such as caring for ones self, walking, seeing, hearing, speaking, breathing, working, performing manual tasks, and learning.

Medical 504 form 2026

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Got questions?

What diagnosis is needed for a 504?

What is a 504 for medical reasons?

What is medical code 504?

Who is required to attend a 504 meeting in Texas?

What are the three steps of the 504 process?

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What are the requirements for 504 in Texas?

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