Penn State’s Documentation Guidelines for Physical Health Disorders

Students seeking academic adjustments, auxiliary aids, and/or services from Penn State University are required to provide diagnostic documentation from a licensed clinical professional familiar with the history and functional limitations of the student’s impairments. All documentation must adequately verify the nature and extent of the disorder in accordance with current professional standards, techniques and practices. Also, the documentation must clearly substantiate the need for the student’s specific academic adjustment, auxiliary aid, and/or service request. All documentation must be submitted on the official letterhead of the professional. The report should be typed, dated, signed, and include the professional credentials of the evaluator including information regarding licensure or certification. The cost of obtaining documentation is borne by the student. If the initial documentation is incomplete or inadequate to determine the extent of the disability and reasonable academic adjustment, auxiliary aid, and/or service, Penn State University has the discretion to require additional documentation. Any cost of obtaining additional documentation is also borne by the student.

Documentation of physical health disorders must include the completion of the Verification Form for Physical Health Disorders by a physician. The completed form must state the current functional limitations of the disorder (documentation for physical health disorders may require periodic updates, especially if changes occur in the student’s functioning). In addition, information provided for physical health disorders must fully explain the following criteria of the student’s disorder (if applicable):

• Medical diagnosis

• Visual Acuity

• Duration (chronic, episodic, or short term) of the condition

• History of the condition and the symptoms related

• Severity (mild, moderate, or severe) and an explanation of the severity

• Dates and frequency of contacts with the student

• Differential diagnoses and reasons for ruling out these diagnoses

• Explanation of how the symptoms related to the student’s condition cause significant impairment in a major life activity

• Detailed explanation of how the impairment limits the student’s functioning for the learning or testing environment

• List of the student’s current medication (dosage, frequency, and adverse side effects) and an explanation of the extent medication mitigates the symptoms of the disorder

• Explanation of any significant limitations in functioning directly related to the prescribed medication

• Specific recommendations regarding academic adjustments, auxiliary aids, and/or services related to the student’s condition and a rationale as to the reason these academic adjustments, auxiliary aids, and/or services are warranted based upon the student’s functional limitations

• Indication as to the reason the stated academic adjustments, auxiliary aids, and/or services are necessary if the current treatments are successful

• Information regarding situations that may exacerbate the student’s condition.

In addition to the Verification Form for Physical Health Disorders, a summary report of the student’s impairment may be submitted.

The Verification Form for Physical Health Disorders can also be obtained from the Office for Disability Services (ODS) located in Room 116 Boucke Building, University Park, PA or call 814- 863-1807 (V/TTY) to have a copy sent to you.

All documentation submitted should be sent with the student’s identifying information (name, social security number, address and phone number). If the student is attending the University Park location, the documentation should be returned to the ODS. If the student is attending another Penn State location, the documentation should be returned to the DCL at the location. Information regarding the DCL at other PSU locations can be found at: http://www.equity.psu.edu/ods/dcl.asp

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Office for Disability Services
The Pennsylvania State University
116 Boucke Building • University Park, PA 16802
Phone: 814 863-1807 (V/TTY) • Fax: 814 863-3217
Copyright 2006-2007 ODS

Web page last modified October 9, 2006