COVID-19 Disability Form


The goal is to complete this form prior to seeking medical attention for COVID-19 symptoms. Having this form, and the accompanying documents noted on page 2 of the form, will help to alert ER physicians to necessary and proper communication with the patient with disabilities and his/her needs and wishes.  It has been reviewed by ER physicians, families of individuals with disabilities and adults with disabilities.

Ballan, M. & Perri, C. (2020). Covid-19 Disability Form. Stony Brook, NY