Recommended Documentation for Disabilities

In order to identify the most appropriate assistance we can offer you, Jackson State needs information from your health care provider(s). Detailed documentation of your diagnoses and need for accommodations should be less than five years old and must be submitted before any adjustments are made. Accommodations are not made retroactively.

Documentation must include: testing and results, interpretive summary with a clear diagnoses, specific recommendations for accommodations as well as an explanation as to how they will assist with your limitations. A disability must limit a major life activity and hinder your ability to function on an equal basis in the classroom or related activities in order to warrant accommodations.

Medical/Physical Disability Documentation Form

Psychological/Psychiatric/ADHD/Learning Disability Documentation Form


Learning Disability:

Evaluation from a licensed school psychologist, licensed psychological examiner, licensed clinical psychologist, or neurophysiologist. Should include psycho-educational evaluation and/or intelligence and achievement tests. Results of a vocational assessment would be helpful. School IEP, history of Response to Intervention (Rtl), and/or Summary of Performance (SOP) also are useful.

Attention Deficit Disorder (ADD/ADHD):

Comprehensive evaluation with clinical interview, historical data, psychological tests, clinical observations by a licensed school psychologist, licensed psychological examiner, licensed clinical psychologist, or neurophysiologist, who has specialized training in assessing ADD/ADHD. School IEP, history of Response to Intervention (Rtl), and/or Summary of Performance (SOP) also are useful.

Psychiatric Disorder:

Information from a licensed psychiatrist or licensed psychologist.

Physical Disability:

A licensed physician' report stating the diagnosis, explanation of physical limitations, medical history, medications, and duration of condition.

Visual Impairment:

Assessment from a licensed optometrist or ophthalmologist.

Hearing Disorder:

Report from an audiologist describing the type and degree of hearing loss.

Traumatic Brain Injury:

Evaluation by a licensed neurophysiologist, licensed orthopedic specialist, licensed speech-language pathologist, and/or other specialists as appropriate.