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Spring 2024 ARS Information!

Read Now for important information about testing accomodations, access and mobility, ARS office operations, and accommodation notifications.

Important: Send accommodation notifications to your professors through the ARS Hub ASAP.

Home/For Students/Documentation Guidelines/Provider Documentation Form

Provider Documentation Form

Licensed health care professionals may use this form to share documentation with ARS. Documentation must substantiate the fact that the condition (disability or chronic medical condition) is present, limiting a major life activity or major bodily function with impacts upon functioning.

Please see our Documentation Guidelines for more thorough information, including guidelines for documentation supporting an Emotional Support Animal request.

Provider Documentation

Professional Clinician/Provider Information

Used to provide you with a copy of this submission for your records and for verification and clarification purposes.
For example the American Board of Pediatrics, American Medical Board, American Psychological Association, American Counseling Association, etc.

Your Client/Patient (the student)

This is a nine-digit student ID number assigned by UNC.

Professional Contact with your Client / Patient

Diagnosis 1

Diagnosis 2

Diagnosis 3

Diagnosis - Other

Diagnostic Information

Select all that apply.

Please attach any relevant documentation.

Please provide specific information about the functional limitations and impacts of the disability or chronic medical condition experienced by the student along with information about the level of severity, frequency and duration of the impacts if applicable as they pertain to the academic and/or residential settings.
Recommendations are welcomed and considered, however ARS makes the ultimate determination on eligibility and reasonable academic adjustments necessary to provide equal access for participation in academic courses, programs and activities. Recommendations should be directly linked to the impact or functional limitations associated with the disability, or medication prescribed to control symptoms and include a clear rationale based on level of impairment.
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