Get the free Visual Impairment Documentation Form - Office of Student Life

Visual Impairment Documentation Form Student Name: ___ DOB: ___/ _/ has requested support services from Accessible Educational Services (AES) at Indiana University Bloomington (PUB) regarding a visual

How to fill out visual impairment documentation form

How to fill out visual impairment documentation form

1. Gather all necessary information such as medical history, visual acuity measurements, and any other relevant medical reports.
2. Complete the personal information section including name, date of birth, contact information, and other required details.
3. Provide details about the visual impairment including the diagnosis, severity, and any limitations it may cause.
4. Include information about any assistive devices or accommodations that are currently being used.
5. Have a healthcare provider or eye specialist complete and sign the form to confirm the visual impairment diagnosis.

Who needs visual impairment documentation form?

1. Individuals who have a visual impairment and require documentation for medical or educational purposes.
2. Organizations or institutions that need proof of an individual's visual impairment status in order to provide accommodations or services.

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What is visual impairment documentation form?

The visual impairment documentation form is a standardized document used to report and verify an individual's visual impairment for the purpose of accessing support services and benefits.

Who is required to file visual impairment documentation form?

Individuals who have been diagnosed with visual impairments and are seeking accommodations, benefits, or services related to their condition are required to file this form.

How to fill out visual impairment documentation form?

To fill out the visual impairment documentation form, individuals must provide personal information, details of their visual impairment, relevant medical documentation, and any supporting evidence from healthcare professionals.

What is the purpose of visual impairment documentation form?

The purpose of the visual impairment documentation form is to formally document the extent of an individual's visual impairment, which helps in the evaluation for eligibility for services and accommodations.

What information must be reported on visual impairment documentation form?

The information that must be reported includes the individual's identity, details about the visual impairment, associated medical conditions, treatments received, and prognosis as provided by a licensed eye care professional.