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Students with Disabilities Services DISPOSITION OF ACCOMMODATION REQUEST Last Name: ___________________ First Name: ___________________ Student ID#: ___________________ Cell Number: _________________ E-mail: ______________________ Term: ________________________ After review of documentation provided the following is appropriate for the student. __ The documentation is insufficient to justify accommodation(s) for the specific disability disclosed. __ The documentation is outdated. ADA guidelines require students to submit current documentation. The UVI Students with Disabilities Services Office requires documentation within 3 years for evaluations but can accept documentation from high school placement within 5 years. The evaluation documentation should be completed and signed by a physician or licensed psychologist/psychiatrist on their letterhead. It should: o Specify the nature, severity, current impact of the disability/medical condition, and anticipate duration; o State the diagnosis in the nomenclature used by the DSM IV or successive editions; o State the student’s medical diagnosis; o Address the student’s current ability to function in the college environment and how the disability/medical condition affects academic performance (e.g. ability to focus, organize one’s time, attend class, work in groups or alone, etc.); o Include a list of accommodations necessary for the student to succeed in an academic setting; o Include medication(s) and the current side effects that may impact the student in an educational setting ______________________________________________________________________________ ___The documentation is comprehensive and complete, and the justification for accommodation is appropriate. The following accommodation(s) would be appropriate: Class Lectures ___ Tape Recorder ___ Referral to VIUCEED for equipment needs based on student’s disability Exams and Quizzes ___ Extended Time for Exams/Quizzes ___ Determined by agreement with instructor ___ Time and 1/2 ___ Double Time ___ Distraction-Reduced for Exams ___ Referral to VIUCEED for equipment needs based on student’s disability ___ Spell Checker- determined by nature of the course and agreement with instructor Deaf/Hard of hearing students ___ Referral to VIUCEED for equipment needs based on student’s disability ___ Sign language Interpreter or Program Visually Impaired/Blind Students ___ Enlarged print for printed materials provided ___ Referral to VIUCEED for equipment needs based on student’s disability ___ Access to Library program which reads for students Computer Adaptive Software ___ Referral to VIUCEED for equipment needs based on student’s disability Reading Accommodations ___ Referral to VIUCEED for equipment needs based on student’s disability ___ Electronic textbooks (E-Texts) Other (please specify): Other recommendations discussed: ___ University Tutoring ___ Early Registration ___ Housing Accommodations ___ Meals ___ Other ___________________________________________________________________________ Medical: Accommodation requested: ___________________________________________________________________ Accommodation granted: _____________________________________________________________________ Disposition: ___ A session was completed with the student to discuss the results of this review, the available resources on campus and the responsibilities of the student for each semester ______________. ___ Student has been advised of the need for updated documentation by the following date: ___________ Date Recommendation made: __________________ ADA Coordinator: _______________________ Student Signature: ______________________________ Date: __________________________________ Form updated: August, 2016