AuthorBehling, Kirsten T.
Bellemore, Eileen H.
Bibeau, Lisa B.
Cioffi, Andrew S.
McNamee, Bridget A.
GroupStudent Accessibility and Academic Resource (StAAR) Center (Tufts University)
Association of American Medical Colleges
Salem State University
Permanent link to this recordhttp://hdl.handle.net/20.500.12613/8835
MetadataShow full item record
DescriptionThis is an example of a pre-intake questionnaire that was designed to facilitate the interactive process. The intention of this form is to 1) gather important information that will inform the intake interview, 2) provide the student with a formal way to disclose their disability, declare impacted major life activities and request individual accommodations, 3) assist the student in structuring their self-report, and 4) inform the student on their rights regarding confidentiality as well as the processes for implementing accommodation plans.
CitationBehling, Kirsten T., Eileen H. Bellemore, Lisa B. Bibeau, Andrew S. Cioffi, and Bridget A. McNamee. 6.2 Student Intake Form. Philadelphia: Temple University Libraries, 2023.
Citation to related workBehling, Kirsten T., Eileen H. Bellemore, Lisa B. Bibeau, Andrew S. Cioffi, and Bridget A. McNamee. Disability Services in Higher Education: An Insider’s Guide. Philadelphia: Temple University Press, 2023.
Available at: https://tupress.temple.edu/books/disability-services-in-higher-education
ADA complianceFor Americans with Disabilities Act (ADA) accommodation, including help with reading this content, please contact email@example.com
Except where otherwise noted, this item's license is described as Attribution-NonCommercial CC BY-NC