Evaluation Forms
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Disability Assessment Form
About this template
A disability assessment form is a questionnaire used by healthcare professionals to evaluate conditions that may be causing a student patient to be unable to study. By filling out a free Disability Assessment Form, patients can be matched with potential accommodations for their disability to improve their ability to work or complete daily activities. This free Disability Assessment Form template can help your medical practice or healthcare organization stay organized and efficient! Simply modify the questions to match the needs of your practice and embed the form on your website — or share it with patients through Google Drive or Dropbox.
Add your logo, change the look and feel of the form, or add more questions to the Disability Assessment Form template to build the exact form you need. If you download Jotform’s free Mobile app, your patients will be able to fill out the form on their mobile devices, even offline! If you’d like to sync your submissions to your CRM or storage platform of choice — or connect to one of our 100+ integrations — you can do it automatically with JotForm. Just remember that your practice is only protected from HIPAA errors if you upgrade to a paid account. Replace paper charts, speed up your practice, and find the best accommodations for your patients with Jotform’s free Disability Assessment Form template.
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