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INCLUSION, DIVERSITY, EQUITY, & ACCESS PHYSICIANS VERIFICATION OF ACCOMMODATIONPlease print legibly and file completed form with the Office of Inclusion, Diversity, Equity & Access (IDEA) located
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How to fill out physicians verification of accommodation
How to fill out physicians verification of accommodation
01
Obtain the form titled 'Physician's Verification of Accommodation' from the appropriate source.
02
Fill out the patient's personal information including name, date of birth, and contact information.
03
Complete the section asking for details of the physician, including name, contact information, and medical license number.
04
Provide a detailed description of the patient's condition and why accommodation is necessary.
05
Have the physician sign and date the form before submitting it to the relevant party.
Who needs physicians verification of accommodation?
01
Individuals who require accommodation for a medical condition or disability.
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What is physicians verification of accommodation?
Physicians verification of accommodation is a form that confirms an individual's need for specific accommodations due to a medical condition.
Who is required to file physicians verification of accommodation?
Individuals who require accommodations due to a medical condition are required to file physicians verification of accommodation.
How to fill out physicians verification of accommodation?
Physicians verification of accommodation can be filled out by a physician who is familiar with the individual's medical condition and need for accommodations.
What is the purpose of physicians verification of accommodation?
The purpose of physicians verification of accommodation is to provide documentation of an individual's medical condition and need for specific accommodations.
What information must be reported on physicians verification of accommodation?
Physicians verification of accommodation should include the individual's medical condition, the specific accommodations needed, and the physician's contact information.
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