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6.2 Student Intake Form
Behling, Kirsten T. Bellemore, Eileen H. Bibeau, Lisa B. Cioffi, Andrew S. McNamee, Bridget A.
Behling, Kirsten T.
Bellemore, Eileen H.
Bibeau, Lisa B.
Cioffi, Andrew S.
McNamee, Bridget A.
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Genre
Instructional material
Date
2023
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DOI
http://dx.doi.org/10.34944/dspace/8799
Abstract
Description
This 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.
Citation
Behling, 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 work
Behling, 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
Available at: https://tupress.temple.edu/books/disability-services-in-higher-education
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ADA compliance
For Americans with Disabilities Act (ADA) accommodation, including help with reading this content, please contact scholarshare@temple.edu