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Massapequa Public Schools SECTION 504 MEDICAL EVALUATION FORM1. 2. 3. 4. 5.INSTRUCTIONS Parent complete Section I of the Section 504 Medical Evaluation Form Parent complete Authorization for Release

How to fill out 504- medical evaluation form

How to fill out 504- medical evaluation form

1. Gather all necessary information, such as the student's medical history, current medications, and any special accommodations they require.
2. Review the 504- medical evaluation form and familiarize yourself with the sections and questions it contains.
3. Start filling out the form by providing the student's personal information, including their name, date of birth, and contact details.
4. Proceed to the medical history section and accurately document any previous illnesses, surgeries, or medical conditions the student has experienced.
5. Complete the medication section by listing all medications the student is currently taking, along with dosage and frequency.
6. Fill in the accommodations section by specifying any reasonable adjustments or modifications the student requires in order to access education and participate fully in school activities.
7. If necessary, attach any supporting documentation, such as medical reports or assessments, that further explain the student's medical needs.
8. Once all sections are completed, review the form for accuracy and ensure all required information has been provided.
9. Obtain necessary signatures from the student's parent or guardian, and any healthcare professionals involved in the evaluation.
10. Make copies of the completed form for your records and submit the original to the appropriate school personnel or department.

Who needs 504- medical evaluation form?

1. Anyone who requires reasonable accommodations in a school setting due to a medical condition or disability may need to fill out a 504- medical evaluation form. This can include students with chronic illnesses, physical disabilities, mental health conditions, or any other medical condition that may impact their ability to fully participate in school activities without accommodations.

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What is 504- medical evaluation form?

504- medical evaluation form is a form used to evaluate a student's medical condition and determine the accommodations they may need in a school setting.

Who is required to file 504- medical evaluation form?

Parents or guardians, along with school officials and medical professionals, may be required to file a 504- medical evaluation form for a student.

How to fill out 504- medical evaluation form?

To fill out a 504- medical evaluation form, one must provide detailed information about the student's medical condition, treatment plan, and any accommodations needed.

What is the purpose of 504- medical evaluation form?

The purpose of 504- medical evaluation form is to ensure that students with medical conditions are provided with appropriate accommodations to support their academic success.

What information must be reported on 504- medical evaluation form?

Information that must be reported on 504- medical evaluation form includes medical diagnosis, recommended accommodations, treatment plan, and any other relevant information.