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Voluntary Disability Disclosure and Request for Accommodation
Voluntary Disability Disclosure and Request for Accommodation
Meredith College is committed to creating an accessible community and providing reasonable accommodations to qualified students. We respect your right to confidentiality and allow you to choose whether or not to disclose your disability and accommodation needs. In a college setting, the student is responsible for initiating the eligibility process and requesting accommodations. Prior to your arrival at Meredith, send the materials requested below to Disability Services so that your accommodations will be in place when you need them.
The needs of individuals with disabilities vary; therefore, we provide a number of support services to students who qualify and are certified with Disability Services. Accommodations and support services are determined on a case-by-case basis.
If you have a learning disability, ADHD, hearing or vision impairment, medical or mental health condition (seizures, diabetes, depression, etc.), mobility impairment, or another disability diagnosis that requires accommodations, please submit the requested materials below.
Complete the Voluntary Disability Disclosure and Request for Accommodations form below.
Submit documentation of the disability from an appropriate licensed/certified professional.
For more specific information about the criteria for documentation, view our Documentation Guidelines online by visiting meredith.edu/disability and selecting the "Certification Process." Documentation
must
include the following standard requirements:
Professional credentials of the evaluator (including licensures and areas of specialty) on official letterhead
A clear diagnostic statement
A complete educational, developmental, and relevant medical history
Identification of the tests and techniques use to arrive at the diagnosis of the disability
Description of the functional limitations resulting from the disability
Specific accommodation recommendations
A detailed explanation of why the disability qualifies the applicant for accommodations
Please submit this form as soon as possible so that Disability Services can begin processing your request for accommodations.
If you require accommodations for admissions, enrollment, and/or advising events, please return this form no later than two weeks prior or contact Counseling Center/Disability Services at (919) 760-8427 or email
disabilityservices@meredith.edu
.
Please submit the following page by June 1.
First Name
Middle Name
Last Name
Social Security number (last four digits only)
Mobile Phone Number
Email Address
Mailing Address
Mailing Address
Country
Street
City
Region
Postal Code
Classification:
Classification:
Adult First Year
First Year
Re-admit
Second Degree
Transfer
What semester are you planning to begin at Meredith?
What semester are you planning to begin at Meredith?
Fall
Spring
Summer
What is your disability? (Give specific diagnosis: learning disability, ADHD, mobility, health, etc.)
How does this disability affect your academic and/or classroom experience?
What, if any, residence hall accommodations, are requested because of your disability?
Housing accommodation requests must be submitted by June 1.
What accommodations have you received in the past?
Information regarding your disability will be treated confidentially and cannot be disseminated without a signed release from you. By checking "Yes" below and signing this form, you give us permission to share information concerning your needs with campus professionals who "need to know" (such as academic advisers and disability counselors). This will NOT release information to your future faculty. A separate release form must be completed
each semester
to communicate information with faculty or other members of the campus community regarding your disability and accommodations.
Yes, I am requesting disability services and understand I must provide appropriate documentation.
Student Signature (Please type your full legal name)
Parent Signature (if student is under 18 years of age)
Submit