Verification of Disability Form for Asthma and Allergy Conditions


The student named below has indicated that s/he has asthma or allergies that rise to the level of disability and will require reasonable accommodations to participate in a program or activity (including housing) at Columbia University. The information you provide will be used to determine the nature and severity of the student’s condition and the appropriateness of requested accommodations or services. Please take the time to complete this form in its entirety. Contact Disability Services (DS) at (212) 854-2388 with any questions. All information provided to us is kept confidential in accordance with the Family Educational Rights and Privacy Act (FERPA). A signed consent for release of information should be completed by the student prior to the release of this form. Thank you for your assistance.