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Documentation Criteria

Documentation Criteria To Register and Receive Accommodations Through ODS

The following guidelines are provided for students identifying themselves as having a disability for which services are needed. To ensure that documentation is complete and appropriate, the following information is needed:

  • A clear statement of the disability, current symptoms which meet the criteria for the diagnosis, and current use of medication.
  • Functional limitation and expected impact on performance, recommendations for accommodations, and a concise statement of credentials.
  • Documentation must be properly prepared by a licensed professional qualified to diagnose and treat the disability.
  • The documentation must be typed or word processed and printed on LETTERHEAD of the practitioner or agency hosting the practice. Handwritten notes on prescription pads ARE NOT accepted

All documentation must be current, within the past THREE years. The exception to this exists in the case of permanent disabilities.

Use the template provided below. Copy and paste the template to the professional's letterhead.

This is a template only. Do Not Fill in the Blanks. Download the pdf version of this template.

Dear Dr. Landry:
[Name] is a client/patient who was last seen at [name of practice] on [date].  He/She has reported to me [issues which lead to the discussion of disability services: i.e. “difficulty in school, particularly performing in the classroom test taking format”].  With this mind, we are requesting you speak with this student regarding any services your office may be able to assist him/her with. The following is the information requested so that these services might be rendered.
1.  His/Her diagnosis is:
  a.  [generalized anxiety disorder, cerebral palsy, etc]
  b.
  c.
2.  Current Symptoms include:
  a.  Anxiety
  b.  easily distracted
  c.
3.  Current use of medication:
  a.  Seroquel XR 150mg QHS
  b.
  c.
4.  Functional limitations and expected impact on performance:
  a.  inability to concentrate in class
  b.  anxiety in test taking situations
  c.  frequent restroom breaks, etc
5.  Credentials:
  a.  Medical doctor with 25 plus years experience in psychiatric medicine, etc.  
If there are any other questions or concerns, please feel free to contact my office.
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