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Medical Certificate–Major Functional Disabilities and Other Recognized Disabilities

Form number: 1015

This form is to be used for applications relating to the September 1, 2017–August 31, 2018 award year.

You need to use this form if you have a major functional or other disability and are applying for the Loans and Bursaries Program or the Allowance for Special Needs Program. 

This form will not be considered valid unless it has been filled out by your doctor.

Digital transmission

Print the form, have your doctor fill it out, and then scan it. Use our Online Services to upload the form.

Other way to submit your document

Mail

If you are unable to submit this form digitally you can mail it to us. Print the form, have your doctor fill it out and mail it to the address shown on the form itself. 

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