Office of Student Accessibility Intake

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BACKGROUND INFORMATION

Additional Identifying Information

Please note: failure to provide a name and ID number in this section may result in a delay in processing this submission.

Questions

Note that our office must meet with you personally and OSA may require third party documentation confirming diagnosis to determine if accommodations will be provided.
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Please provide examples for each disability for which you are exploring accommodations.
Have you used accommodations, assistive technology, and/or auxiliary aids in the past?
What accommodations do you anticipate possibly using while at Lewis & Clark?

Please note that this does not guarantee all will be provided. For more information on some common accommodations, visit this link.

Campus Living Physical Assistance Release

In order to ensure the safety of our students, OSA maintains a list of students who may need physical assistance in an emergency. Please select if you would like to be included on this list. If you live on campus, your name will be shared with Campus Living.

On Campus Resources

LC provides a variety of services to help you become/remain a successful student. Which of the following would you like to learn more about? (select all that apply) For more information on on-campus resources: On-Campus Resource Link https://www.lclark.edu/offices/student-accessibility/on-campus-resources/

Did you receive a letter to meet with Gaby Herrmann in the Office of Student Accessibility?
Are you a Continuing Education Student?
Upload supporting document(s)

Documentation should come from a qualified licensed professional (doctor, therapist, 504/IEP documents, etc.) and state your diagnosis/es, the impact of these on your ability to access your education, and recommendations for accommodations.

It's best if this documentation is from within the last 5 years. If you are submitting an IEP or a 504 plan, please also include the plan’s evaluation/eligibility paperwork. This paperwork may be titled “psychoeducational evaluation,” “psychological evaluation,” “cognitive evaluation,” “social-emotional evaluation,” “speech and language evaluation,” “academic evaluation,” or “achievement evaluation.”

If you have documentation that is more than 5 years old, bring it so we can discuss it with you. If you do not have documentation, we can discuss this further during your initial appointment.