Documentation Requirements

Please have a physician fill out the Medical Health Verification Form

An IEP with a psycho-educational evaluation may be accepted as documentation if the information included addresses the above requirements

504 Plans will be reviewed to determine if further evidence or information is required

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Please provide recent audiological documentation from a certified audiologist that is on the provider’s letterhead, date, and signed by the provider.

Documentation must include:

• Diagnosis
• Prognosis
• Academic Limitations (if any)
• Severity of Hearing Loss and Impact of Diagnosis

An IEP may be provided, but a current audiology report will be needed as well.

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Please have a physician fill out the Medical Health Verification Form

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Please have a licensed provider fill out the Mental Health Verification Form

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Please have a physician fill out the Medical Health Verification Form

An IEP with a psycho-educational evaluation may be accepted as documentation if the information included addresses the above requirements

504 Plans will be reviewed to determine if further evidence or information is required

Back To Top