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Please provide medical documentation to support the above description of your temporary medical condition.
I understand that completing this form is only the initial step in the temporary accommodation process. Once I have provided this intake and documentation about my medical condition, I will need to meet with the Director of Disability Services to request accommodations and provide notification to instructors. As an alternative, if you are not able to meet on campus, you can complete the Online Request for Accommodations Form.
I also understand that I am my own advocate. It is my responsibility to request accommodations and to notify instructors of my need for accommodations. It is also my responsibility to report any concerns I may have regarding accommodations to the Disability Services Office.
I affirm that the information contained in this form is true and accurate to the best of my knowledge. If any information changes, I will notify the Disability Services Office immediately.
North Iowa Area Community College (NIACC) is committed to providing reasonable accommodations to qualified students with temporary medical conditions. These accommodations are provided to assist students in accessing education at NIACC. Working in partnership with the student, the Disability Services Director will develop an individual plan for services. Please note that program requirements will not be altered and standards will not be lowered when providing reasonable accommodations. Each situation will be reviewed on an individual case-by-case basis.
NIACC Disability Services is committed to ensuring that all information and communication pertaining to a student's medical condition is maintained as confidential as required or permitted by law. The following guidelines about the treatment of such information have been adopted by NIACC Disability Services. These guidelines incorporate relevant state and federal regulations.
I have been informed of the policy regarding confidentiality and the release of information from my NIACC Disability Services file. I understand that NIACC Disability Services may release information from my file to be used in a confidential manner with appropriate college faculty & staff and officials who have a legitimate educational interest while I am a student at North Iowa Area Community College.