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Disability Verification Form

Disability Verification Form


A disability verification form is a document prepared by verification department and officials to frame a layout for testing the disability criterion and also corresponding details placed therein. The form is a structural representation of the confirmation and also proof of details produced in this area of disability and related aspects.

Disability Verification Template
Disability Verification Template
Disability Verification Template
Disability Verification Template

You can Download the Disability Verification Form Template, customize it according to your needs, and Print it. Disability Verification Form Template is either in MS Word or Editable PDF.

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Candidate Information:

The form collects basic information about the candidate, such as name, date of birth, and contact details.


It typically includes a section where the candidate grants permission to release information about their disability to the requesting entity.

Healthcare Provider Information:

The form often includes a section for the candidate to provide contact information for their healthcare provider who can verify the disability.

Nature of Disability:

The form may or may not ask for details about the nature of the disability.

Functional Limitations:

Some forms may have a section for the healthcare provider to outline any functional limitations caused by the disability.



The form ensures that all the necessary information is collected from the candidate in a consistent format. This can also help to streamline the verification process for employers and other institutions.

Privacy Protection:

By requiring the candidate’s authorization, the form helps to protect the privacy of their medical information.

Verification of Disability:

The form provides a mechanism for employers and other institutions to obtain verification of a candidate’s disability from a qualified healthcare professional.

Accommodation Requests:

The information gathered through the form can also be used to determine appropriate accommodations for the candidate.

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