Office Of Accessibility And Disability Services Verification Of A Disability printable pdf download

Office Of Accessibility And Disability Services Verification Of A Disability

Office of Accessibility and Disability Services

VERIFICATION OF A MEDICAL DISABILITY

Coastal Carolina University, through the Office of Accessibility and Disability Services,

provides services to students with diagnosed medical/physical disabilities in accordance

with the Americans with Disabilities Act (ADA) of 1990 and Section 504 of the

Rehabilitation Act of 1973. To determine eligibility for services, this office requires

current and comprehensive documentation of the disability or medical condition from the

diagnosing physician or other appropriate professional. The student named below is

requesting services from our office at this time. In order to help us serve this student in

the best possible manner, please complete the following form ASAP and return it to the

below address or fax number. No services will be available to this student until this

form has been received. Please note that a separate form is required for an AD/HD

diagnosis.

Name of Student:___________________________ Student ID:____________________

1. Diagnosis, date of diagnosis and last contact with this student.

2. Describe symptoms associated with this medical condition.

Office Of Accessibility And Disability Services Verification Of A Disability