ODS Pre-Registration

Student Self-Assessment

 

Name/Class ______________________

 

Date completed ____________________

 

 

1.   What is your disability, and when was it first diagnosed?

 

 

 

 

 

 

2.   What disability-related accommodations have you used  

in the past – either in or out of the classroom?   

 

 

 

 

 

 

3.   What accommodations do you anticipate needing this semester?

 

 

 

 

 

 

 

 

4.    Who referred you to ODS - or did you come independently (via self referral)?

 

 

 

 

 

 

 

ODS

8/08
 

22