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Medical Evidence Form

This document outlines the process for medical practitioners to provide evidence supporting adjustments for students with disabilities or conditions during examinations. It details the information required, including the nature of the condition, its duration, and how it affects exam performance, as well as the specific adjustments needed. The document emphasizes that adjustments must be reasonable and submitted at least 28 days before exams, with a note on the review process by the Disability Support and Inclusion Service.

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6 views

Medical Evidence Form

This document outlines the process for medical practitioners to provide evidence supporting adjustments for students with disabilities or conditions during examinations. It details the information required, including the nature of the condition, its duration, and how it affects exam performance, as well as the specific adjustments needed. The document emphasizes that adjustments must be reasonable and submitted at least 28 days before exams, with a note on the review process by the Disability Support and Inclusion Service.

Uploaded by

rajive65
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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MEDICAL EVIDENCE TO SUPPORT ADJUSTMENTS FOR EXAMINATION ARRANGEMENTS

To be completed by a medical practitioner

If a student has a disability/condition (including short-term/temporary conditions such as broken bones),


they may request adjustments to be put in place for their examinations and course. To enable the
University to provide any such facilities, evidence is required to ensure we are providing the most
appropriate ones.
We would be grateful if you could complete this form to provide us with relevant information.

NAME OF PATIENT:

WHAT CONDITION/DISABILITY DOES THE PATIENT HAVE?


Please note that exam stress/anxiety/panic or nerves are experienced by many students and this in itself is
not normally a sufficient reason to provide additional facilities. However, reasonable adjustments for
debilitating conditions that could otherwise impair performance can be considered, e.g. stop the clock
breaks. If the student is stating they have pain in their hand/wrists/back/neck etc please state the
diagnosed condition.

HOW LONG HAS THE PATIENT HAD THE MEDICAL CONDITION/DISABILITY?


If the condition is temporary, please also state how long you expect the patient to be affected.

HOW WOULD THE CONDITION ADVERSELY AFFECT THE STUDENT IN A WRITTEN


EXAMINATION?
Please mention any medication that the student is currently taking that may have a substantial impact on
their performance on written exams e.g. fatigue or loss of concentration.

WHAT EXAM ADJUSTMENTS WOULD THE STUDENT REQUIRE IN A WRITTEN EXAMINATION?

Please note the following:


 Standard additional time is-15 minutes per hour
 Standard stop the clock breaks (rest breaks) are-10 minutes per hour
 For students with panic attacks/anxiety/depression the standard exam adjustment is stop the clock
breaks. If you are recommending another exam adjustment instead of stop the clock breaks please
let us know why.
HOW WOULD THE CONDITION ADVERSELY AFFECT THE STUDENT IN AN ORAL EXAMINATION
AND WHAT ADJUSTMENTS ARE REQUIRED FOR AN ORAL EXAMINATION?
Please mention any medication that the student is currently taking that may have a substantial impact on
their performance on oral exams e.g. slurred speech or loss of concentration.

HOW WOULD THE CONDITION ADVERSELY AFFECT THE STUDENT WHILE STUDYING THEIR
COURSE AND WHAT COURSE ADJUSTMENTS ARE REQUIRED?

Examples of course adjustments:


 Extended library loans
 Students to attend alternative lectures when their condition precludes their attendance in their
scheduled lecture.
 To be provided with PowerPoint slides used in lectures and workshops

Please note that the recommendations made in this form will be reviewed by the Disability Support and
Inclusion Service.
We will only put recommendations in place if they are a reasonable adjustment, therefore some
recommendations may not be put in place.
We do not put in place exam adjustments based on what the student wants, exam adjustments are there to
put students with disabilities/medical conditions on a level playing field.

Applications for exam adjustments must be submitted to the Disability Support and Inclusion
Service at least 28 days before the start of your exam period.
Where there is less than 28 but more than 21 days given, the University will make every effort to ensure
that facilities requested are out in place, we are unable to guarantee this in the build-up to the
examinations. If we are unable to provide the facilities, students can choose to absent themselves from the
examinations and enter a concession application for the absence, explaining the situation including the
reason for late disclosure. Further details on concession application can be obtained from the course
handbook, the assessment regulations and the Campus assessment office staff.

Please can you:

Sign this form. Signed:

Insert the date: Dated:

Stamp the form with your office stamp. (If you do not have an office stamp, please attach a sheet of blank
letter-headed paper).Stamp:

© The University of Law 2019

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