Form Revis ed on 7.21.2015 by RMN
Name of Student: ________________________________ Name of Diagnostician: _______________________
Diagnostician Contact Information: _________________________________________________________________
(Include, Address and Phone Number)
Note: Please refer to pages 2-3 of this form for best practices guidelines in the documentation of a
disability for accommodations at the postsecondary level. Feel free to substitute a signed and dated
letter on your institutional letterhead in lieu of this form.
What is your diagnosis of the above named student’s disability?
What was the approximate date of this diagnosis?
How was this diagnosis reached?
How does this disability affect one or more of the student’s major life activities?
How does this disability affect the student’s academic performance?
Based upon the nature and extent of the disability, what accommodations would you
recommended as reasonable and appropriate?
What are your credentials as they relate to the student’s diagnosed disability?
Signature: ____________________________________ Date: ______________
Best Practices: Disability Documentation in Higher Education
From the Association on Higher Education and Disability
Seven Essential Elements of Quality Disability Documentation
The dimensions of good documentation discussed below are suggested as a best practices approach
for defining complete documentation that both establishes the individual as a person with a
disability and provides a rationale for reasonable accommodations. By identifying the essential
dimensions of documentation, institutions allow for flexibility in accepting documentation from the
full range of theoretical and clinical perspectives. This approach will enhance consistency and
provide stakeholders (students, prospective students, parents and professionals) with the information
they need to assist students in establishing eligibility for services and receiving appropriate
1. The credentials of the evaluator(s)
The best quality documentation is provided by a licensed or otherwise properly credentialed
professional who has undergone appropriate and comprehensive training, has relevant
experience, and has no personal relationship with the individual being evaluated. A good match
between the credentials of the individual making the diagnosis and the condition being reported
is expected (e.g., an orthopedic limitation might be documented by a physician, but not a
licensed psychologist).
2. A diagnostic statement identifying the disability
Quality documentation includes a clear diagnostic statement that describes how the condition
was diagnosed, provides information on the functional impact, and details the typical
progression or prognosis of the condition. While diagnostic codes from the Diagnostic Statistical
Manual of the American Psychiatric Association (DSM) or the International Classification of
Functioning, Disability and Health (ICF) of the World Health Organization are helpful in providing
this information, a full clinical description will also convey the necessary information.
3. A description of the diagnostic methodology used
Quality documentation includes a description of the diagnostic criteria, evaluation methods,
procedures, tests and dates of administration, as well as a clinical narrative, observation, and
specific results. Where appropriate to the nature of the disability, having both summary data and
specific test scores (with the norming population identified) within the report is recommended.
Diagnostic methods that are congruent with the particular disability and current professional
practices in the field are recommended. Methods may include formal instruments, medical
examinations, structured interview protocols, performance observations and unstructured
interviews. If results from informal, non-standardized or less common methods of evaluation are
reported, an explanation of their role and significance in the diagnostic process will strengthen
their value in providing useful information.
4. A description of the current functional limitations
Information on how the disabling condition(s) currently impacts the individual provides useful
information for both establishing a disability and identifying possible accommodations. A
combination of the results of formal evaluation procedures, clinical narrative, and the individual’s
self report is the most comprehensive approach to fully documenting impact. The best quality
documentation is thorough enough to demonstrate whether and how a major life activity is
substantially limited by providing a clear sense of the severity, frequency and pervasiveness of
the condition(s).
While relatively recent documentation is recommended in most circumstances, common sense
and discretion in accepting older documentation of conditions that are permanent or non-
varying is recommended. Likewise, changing conditions and/or changes in how the condition
impacts the individual brought on by growth and development may warrant more frequent
updates in order to provide an accurate picture. It is important to remember that documentation
is not time-bound; the need for recent documentation depends on the facts and circumstances
of the individual’s condition.
5. A description of the expected progression or stability of the disability
It is helpful when documentation provides information on expected changes in the functional
impact of the disability over time and context. Information on the cyclical or episodic nature of
the disability and known or suspected environmental triggers to episodes provides opportunities
to anticipate and plan for varying functional impacts. If the condition is not stable, information
on interventions (including the individual’s own strategies) for exacerbations and recommended
timelines for re-evaluation are most helpful.
6. A description of current and past accommodations, services and/or medications
The most comprehensive documentation will include a description of both current and past
medications, auxiliary aids, assistive devices, support services, and accommodations, including
their effectiveness in ameliorating functional impacts of the disability. A discussion of any
significant side effects from current medications or services that may impact physical, perceptual,
behavioral or cognitive performance is helpful when included in the report. While
accommodations provided in another setting are not binding on the current institution, they may
provide insight in making current decisions.
7. Recommendations for accommodations, adaptive devices, assistive services, compensatory
strategies, and/or collateral support services.
Recommendations from professionals with a history of working with the individual provide
valuable information for review and the planning process. It is most helpful when recommended
accommodations and strategies are logically related to functional limitations; if connections are
not obvious, a clear explanation of their relationship can be useful in decision-making. While the
post-secondary institution has no obligation to provide or adopt recommendations made by
outside entities, those that are congruent with the programs, services, and benefits offered by
the college or program may be appropriate. When recommendations go beyond equitable and
inclusive services and benefits, they may still be useful in suggesting alternative accommodations
and/or services.