Oregon State University ESA Documentation Form
This document provides guidelines for requesting an Emotional Support Animal (ESA) at Oregon State University. It includes necessary documentation requirements and instructions on how to properly complete the form. Ensure you fulfill the criteria outlined to facilitate a smooth accommodation process.
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How do I fill this out?
To fill out this form, gather the required information about the student and the recommended Assistance Animal. Ensure that the qualified professional completing the form provides thorough answers to each question. Submit the completed form as indicated in the instructions to initiate your request.
How to fill out the Oregon State University ESA Documentation Form?
1
Gather relevant documentation from a qualified mental health provider.
2
Complete the Student Contact Information section carefully.
3
Ensure all questions regarding diagnosis and treatment are answered thoroughly.
4
Have the professional provide their signature and credentials.
5
Submit the completed form as per the provided instructions.
Who needs the Oregon State University ESA Documentation Form?
1
Students with documented disabilities who require emotional support.
2
Mental health professionals prescribing an ESA for treatment.
3
University housing administrators needing accommodation details.
4
Parents or guardians of students with disabilities seeking support.
5
Advisors or counselors assisting students in the accommodation process.
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What are the instructions for submitting this form?
To submit this form, send it via email to ds@oregonstate.edu or fax it to 541-737-7354. You may also drop off a physical copy at the Disability Access Services office located at A200 Kerr Administration Bldg., Corvallis, Oregon 97331. Make sure to retain a copy for your records and follow up if you do not receive a confirmation of receipt.
What are the important dates for this form in 2024 and 2025?
For the 2024 and 2025 academic years, ensure that all forms are submitted by the deadlines indicated in the university housing calendar. The Fall term begins September 20, 2024, and the Winter term starts January 6, 2025. Check the website annually for updates regarding submission periods.
What is the purpose of this form?
The purpose of this form is to facilitate students with documented disabilities in requesting an Emotional Support Animal (ESA) for their living environment. The form provides a method for mental health professionals to document the need for an ESA as part of the student’s accommodation process. It aims to ensure that students have equal opportunity to enjoy university housing while receiving necessary support.
Tell me about this form and its components and fields line-by-line.
- 1. Student's Name: The full name of the student requesting the ESA.
- 2. Date of Birth: The student's date of birth for identification purposes.
- 3. Phone Number: The contact number of the student.
- 4. Student ID Number: A unique identification number assigned to the student.
- 5. Provider Name: The name of the mental health professional completing the form.
- 6. Diagnosis: Details regarding the student's diagnosis as per DSM-V.
- 7. Severity Level: Indicates the severity of the diagnosis affecting housing.
- 8. Provider Signature: The signature of the mental health professional.
What happens if I fail to submit this form?
Failure to submit this form accurately may result in delays or denials of your ESA request. It is essential to provide complete and thorough information to ensure that your needs are properly evaluated.
- Inaccurate Information: Providing false or incomplete information may lead to complications in the review of your request.
- Delayed Response: An incomplete form may cause delays in processing your accommodation request.
- Denial of Accommodation: Failure to fulfill the submission requirements may result in denial of housing accommodations.
How do I know when to use this form?
- 1. Residential Housing Requests: To request an ESA for on-campus housing accommodations.
- 2. Documentation for Disability Access Services: To provide necessary information to Disability Access Services regarding the need for an ESA.
- 3. Compliance with University Policies: To ensure adherence to university guidelines regarding emotional support animals.
Frequently Asked Questions
How can I edit this PDF?
You can edit this PDF by opening it in the PrintFriendly editor and making changes directly to the text and fields.
Can I save the edited PDF?
Yes, after editing, you can download the PDF document for your records.
Who needs this form?
Students with disabilities and their mental health providers may need this form to request an ESA.
How do I submit the completed form?
Follow the instructions provided in the PDF for submission details.
What if I need assistance filling this out?
Reach out to Disability Access Services for guidance on completing the form.
Is there a deadline for submission?
Please refer to the important dates section of the form for any specific deadlines.
Can I share the PDF with others?
Absolutely! You can share the PDF via email or direct links.
What should I do if I have questions about the ESA policy?
Contact Disability Access Services for comprehensive information about their ESA policy.
What information do I need to complete the form?
You’ll need information from your mental health provider as well as your personal details.
How do I know if I qualify for an ESA?
Consult with a qualified mental health professional who can assess your needs.
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