Guidelines for Documentation of a Physical/Psychiatric Disability

To qualify for services, a student must provide documentation of disability as determined by a licensed physician and/or certified psychologist or other specialist (e.g., audiologist, optometrist, chiropractor) who is skilled in the diagnosis of such a disability.

  1. The documentation must include the following:
    • Clear statement of diagnosis, and whether it substantially limits one or more major life activities such as: walking, seeing, hearing, learning or working.
    • Date of diagnosis, including prognosis. Is the condition expected to improve over time or is it permanent?
    • Statement of impact and limitations on academic performance in a university classroom. Include medical history related to current use of medication and the impact of medication on the student’s ability to meet the demands of the academic program.
    • Recommendations for academic adjustments to compensate for the disability.
  2. Documentation must be on letterhead, and include the name and title of the practitioner, signature and date.
  3. Some conditions, due to their changing nature, may warrant additional updated documentation in the future.
  4. Accommodations are always individually determined. Once the PASS office receives documentation, the student has the responsibility to make an appointment to discuss his/her eligibility to receive accommodations.

All documentation is confidential and should be submitted to:

Plymouth State University
Plymouth Academic Support Services
MSC 9
17 High Street
Plymouth, NH 03264
Fax: (603) 535-2277

*Reviewed by USNH Counsel 3/02.

Students may submit the above or may choose to have the provider complete the Physical Disability Form or the Psychiatric Disability Form and submit whichever is applicable as an alternative.