This form is intended for use in obtaining information from a medical provider regarding physical disabilities. This form can NOT be used for ADD/ADHD or Psychiatric Disorders (Depression, Bi-Polar, Anxiety Disorder, etc.) or Learning Disabilities.
Please be aware that additional documentation may be required by the Office for Students with Disabilities. You may also want to see information regarding documentation guidelines.
Submitting Your Form
Please complete the form and either fax it to (817) 272-1447, or mail it to Box 19510; University Hall, Room 102; Arlington, TX 76019-0510, or hand deliver it to the OSD office located in Room 102, University Hall.