Accessibility Services: Forms & Downloads
Forms & Downloads
This page provides access to downloadable forms that students can use when requesting accommodations at Georgian Court University. These forms are designed to assist healthcare providers in submitting the appropriate documentation required for disability verification and accommodation requests.
Important Notes:
- These forms are optional – students may also submit comprehensive evaluation reports or letters from qualified professionals that meet our documentation guidelines
- Forms must be completed by qualified, licensed professionals who are not related to the student
- All forms should be submitted on official letterhead with the provider’s signature and credentials
Submission Information
Methods of Submission:
- Email: lfahr@georgian.edu
- In Person: Jeffries Hall, Room 130
- Mail: Office of Accessibility Services, Georgian Court University, 900 Lakewood Avenue, Lakewood, NJ 08701
Documentation Guidelines:
For detailed information about documentation requirements for each disability category, please visit our Documentation Guidelines page.
Confidentiality:
All documentation submitted is maintained securely and confidentially in compliance with:
- Family Educational Rights and Privacy Act (FERPA)
- Americans with Disabilities Act (ADA)
- Section 504 of the Rehabilitation Act
Available Forms
Purpose: For students with chronic medical conditions, neurological conditions, or mobility impairments
This form should be completed by a licensed healthcare provider to document:
- Current diagnosis and medical history
- Functional limitations in an academic setting
- Current treatments and medications
- Specific accommodation recommendations
Who Should Complete: Licensed physicians, nurse practitioners, or other qualified medical professionals
Purpose: For students with psychological or mental health conditions
This form should be completed by a qualified mental health professional to document:
- DSM-5 diagnosis and clinical assessment
- Functional impact in academic settings
- Current treatment and medications
- Recommended accommodations and rationale
Who Should Complete: Licensed psychologists, psychiatrists, or licensed clinical social workers
Purpose: For students with Attention-Deficit/Hyperactivity Disorder
This form should be completed by a professional experienced in diagnosing ADHD/ADD to document:
DSM-5 diagnosis and developmental history
Assessment procedures used
Functional limitations affecting academic performance
Medication management and accommodation recommendations
Who Should Complete: Clinical psychologists, neuropsychologists, psychiatrists, or medical doctors with ADHD expertise
Purpose: For students on the autism spectrum
This form should be completed by a professional with training and expertise in autism spectrum disorders to document:
- DSM-5 autism spectrum disorder diagnosis
- Assessment tools and procedures used
- Current functional limitations
- Academic accommodations and support recommendations
Who Should Complete: Psychologists, psychiatrists, neurologists, or other qualified clinicians with autism expertise
Purpose: For students who believe they have experienced discrimination or failure to accommodate
This form allows students to file a formal grievance regarding:
Denial or delay of accommodations
Failure to implement approved accommodations
Discrimination based on disability
Inaccessibility of campus facilities or programs
Who Should Complete: Students registered with Accessibility Services
Need Help?
For Students: If you need assistance completing these forms or have questions about the accommodation process, please contact:
- Luana Fahr: Director of Student Success and Academic Support/Accessibility Officer
Email: lfahr@georgian.edu
Phone: 732-987-2646
For Healthcare Providers: If you are a healthcare provider and need clarification about documentation requirements or accommodation recommendations, please feel free to contact our office directly.
Office Information:
- Location: Jeffries Hall, Room 130
- Phone: 732-987-2646
- Email: lfahr@georgian.edu
- Office Hours: Monday – Friday, 8:00 AM – 5:15 PM
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Luana Fahr
Director of Student Success and Academic Support/Accessibility Officer - Jeffries Hall, Room 130
- Phone: (732) 987-2646
- Email: lfahr@georgian.edu