PRINTED ON OFFICE OF DISABILITY SERVICES LETTERHEAD
ODS Release Form
| I, __________________________ , a student
registered with the
Office of Disability Services, give ODS permission for the following:
|
|
| ______ | to give my name/email/phone# to a prospective student with a similar disability |
| ______ | to provide my name/email/phone# to a current Barnard student with a similar disability |
| ______ | to contact my clinician regarding certification of
disability clinician name/phone#:____________________________ |
| ______ |
to send my email address to an ODS E-Mentor |
| ______ | to send my documentation to: _____________________ |
___________________
signature
___________________
date
ODS 8/08
25