Certification Forms for Physical Health Disorder

Villanova University provides academic adjustments and/or services to students with disabilities. In order for a student to be eligible for academic adjustments and/or services, the student’s documentation regarding the disorder must demonstrate a disability covered under Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act (ADA) of 1990. These laws define a disability as a physical or mental impairment that substantially limits one or more major life activities. To determine eligibility for academic adjustments and/or services, Villanova requires current and comprehensive documentation of the student’s disorder. It is the responsibility of the student to obtain documentation and present a copy to Learning Support Services.

Documentation of a physical health disorder must include the completion of the Verification Form for Physical Health Disorders by a physician (documentation for physical health disorders may require periodic updates, especially if changes occur in the student’s functioning or requests for academic adjustments and/or services change). In addition to the Verification Form for Physical Health Disorders, a summary report of the student’s disorder may be submitted.

  • Presenting concerns at the time of evaluation
  • History (developmental, family, medical, psychosocial, pharmacological, educational, and employment)
  • Current symptoms
  • A diagnosis
  • Functional limitations
  • Summary and recommendations

This form must be completed in full. Professionals conducting the assessment and rendering a diagnosis must be qualified to do so (e.g., a licensed physician). It is not appropriate for professionals to evaluate members of their family or others with which they have personal or professional relationships. This provider signing this form must be the same person answering the questions on the form.

Certification Forms for Physical Health Disorder

Office of Learning Support Services:
Villanova University
Learning Commons in Falvey
800 Lancaster Avenue
Villanova, PA 19085

Phone: 610.519.5176
Fax: 610.519.8015
Email: learning.support.services@villanova.edu