• 填写并提交 学生住宿申请表 and upload the required documentation to support your request.
• 文件必须是最新的，并由医疗专业人员或卫生保健提供者由在诊断所针对的领域获得许可或认证的专业人员编写..  Letter must be typed on office/practice letterhead, 过时的, and 医生签名.
• 如果适用的话, provide a copy of your complete Individualized Education Plan (IEP), 业绩总结(SOP), 或者504计划.  Although additional physician documentation may be requested, this may help to support your request.

For additional assistance contact the Office of Disability Services, OneStop Student Service Center.

学生住宿申请表

需要的文档

确定学生的住宿需求, 学院需要一名合格的医生出具的官方文件，该医生可以诊断和治疗你的身体状况.

你可以:

• Submit a current physicians report (within 5 years) such as a neuro心理, 心理, or ADHD testing report specifying a diagnosis of ADHD, 由审查员签名并注明日期;

or

• 提交由有资格的医生出具的当前正式文件，该医生有资格诊断和治疗您的医疗状况.  The physicians report should be typed on the physician’s letterhead, 过时的, 签署, 包括名字, title, 以及评估人员的专业证书 along with the following information:

1. Diagnostic code (DSM-IV, IV-R, V), 诊断日期, and 上次到访日期.
2. 病情严重程度:轻度, 温和的, or severe and provide examples as it relates to patients  medical condition.
3. 你是如何得出诊断结果的? Possible responses include: structured or unstructured interviews with the student or other persons, 行为观察, 发展/病史, 教育历史, 等级量表, 等.
4. 学生服用什么药物治疗ADHD? 服药后症状还会持续吗?
5. 详细描述ADHD目前对学生生活的两个或两个以上主要方面的影响，因为住宿将根据这些信息确定.
6. List ADHD symptoms which were present before the 年龄 of 7.
7. 请列出并解释可能影响该学生学业成绩的其他医疗状况或精神诊断.

需要的文档

提交由有资格的医生出具的当前正式文件，该医生有资格诊断和治疗您的医疗状况.  The physicians report should be typed on the physician’s letterhead, 过时的, 签署, 包括名字, title, 以及评估人员的专业证书 along with the following information:

1. 当前的诊断代码(DSM-IV), IV-R, V), 诊断日期, 上次到访日期, and
   severity of the condition, 以及治疗历史和治疗计划.
2. The impact of the disorder on the individual should be discussed with particular detail
   关于学术要求. 文件只包括诊断，图表
   notes, 和/或处方便笺簿符号不足. 
3. If specific recommendations of accommodations are made, the rationale must relate the
   accommodation to the functional limitations imposed by the disability.
4. What medication(s) does the student take for emotional/精神 health support? Do
   即使服药，症状也会持续存在?
5. A current neuro心理 or 心理 evaluation report may allow the student
   更彻底地适应.

需要的文档

以下专业人士被认为有资格评估和诊断自闭症谱系障碍:心理学家, 精神科医生,发育儿科医生,神经学家, 或者一个跨学科的团队.

All reports should be typed on physicians letterhead, 过时的, 签署, 包括名字, title, 以及评估人员的专业证书.

• A psychoeducational report including social-behavioral testing should be current within five years. 文件应根据学生目前在教育环境中的功能证明服务的需要. If the student has been evaluated by an autism center such as TEACCH, please include the evaluation in the submitted documentation.
• 明确的疾病诊断说明, 包括dsm - iv, IV-R, 或V型诊断, and a summary of present symptoms must accompany the documentation. 除了, 评估程序摘要, 使用的诊断测试, 并应包括评价结果.  A comprehensive report would include: ability testing, 成就测试, and specific cognitive processing evaluated for strengths and weaknesses, 包括视觉空间处理

斯洛松智力测验和考夫曼简短智力测验是主要的筛选工具 不 comprehensive enough to provide the information necessary to make accommodation decisions.  广域成就测验 不是 成就和的综合衡量标准, 因此, 难道没有用作为衡量成就的唯一标准吗.

残疾对个人的影响应在学术和社会要求方面进行特别详细的讨论. If specific recommendations of accommodations are made, the rationale must relate the accommodation to the functional limitations imposed by the disability.

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• 必须由持牌听力学家提供指示听力损伤严重程度的听音图.
• If specific recommendations of accommodations are made, the rationale must relate each accommodation to the functional limitations imposed by the disability.
• If other disabilities are present, please provide additional reports.

需要的文档

以下适当许可/认证的临床专业人员被认为有资格评估和诊断学习障碍:心理学家, 学校心理学家, 和神经心理学家.  专业人员必须具备评估学习障碍对学生学习成绩影响的专业知识. All reports should be on typed on physicians letterhead, 过时的, 签署, 包括名字, title, 以及评估人员的专业证书.

• A psychoeducational report should be current within five years. 文件应根据学生目前在教育环境中的功能证明服务的需要.
• A psychoeducational evaluation should include a clinical interview. 学生的发展, 学术, 精神, and social history should be investigated and reported. This evaluation must include a comprehensive assessment battery including aptitude, 成就, 加工仪器.

下列能力倾向测试被认为是证实有学习障碍的适当方法:

• Wechsler Adult Intelligence Scale-IV (WAIS-IV); Wechsler Intelligence Scale for Children-IV (WISC-IV)
• Woodcock-Johnson Test Psychoeducational Battery-III: Test of Cognitive Ability
• Kaufman Adolescent and Adult Intelligence Test (KAIT)

斯洛松智力测验和考夫曼简短智力测验主要是筛选设备，它们不够全面，无法提供做出住宿决定所需的信息.

以下成绩测试被认为是证实有学习障碍的适当方法:

• Woodcock-Johnson Psychoeducational Battery-III: Tests of Achievement
• Wechsler Individual Achievement Test-II (WIAT-III)
•成人学业能力测试(SATA)

广域成就测验 不是 成就和的综合衡量标准, 因此, 难道没有用作为衡量成就的唯一标准吗.

残疾的影响应在学术要求方面进行特别详细的讨论. If specific recommendations of accommodations are made, the rationale must relate the accommodation to the functional limitations imposed by the disability.

需要的文档

文件应由有资格诊断残疾的持牌医生/临床医生准备. All documentation must be typed on physicians letterhead, 过时的, 医生签名, 并提供医生证书.  报告还应包括:

• 带有诊断日期的当前诊断, 上次到访日期, 病情的严重程度也应该包括在内, 以及治疗历史和治疗计划.
• 这种情况对个人的影响应该与学术要求的具体细节进行讨论. 文件只包括诊断，图表 notes, 和/或处方便笺簿符号不足. 不提交手写文件.
• If specific recommendations of accommodations are made, the rationale must relate the accommodation to the functional limitations imposed by the disability.
• What medication(s) does the student take for emotional/精神 health support? 服药后症状还会持续吗?  In cases of head trauma or medical conditions which affect the brain, 当前的神经心理学或心理评估报告可以让学生更彻底地适应.

需要的文档

Documentation should be prepared by a licensed/clinical: psychologist,精神病学家, orother professional qualified to diagnosis emotional/精神 health disabilities.  The physicians report should be typed on the physician’s letterhead, 过时的, 签署, 包括名字, title, 以及评估人员的专业证书 along with the following information:

• 当前的诊断代码(DSM-IV), IV-R, V), 诊断日期, 上次到访日期, 病情的严重程度也应该包括在内, 以及治疗历史和治疗计划.
• 这种障碍对个人的影响应该在学术要求方面进行详细讨论. 文件只包括诊断，图表 notes, 和/或处方便笺簿符号不足.
• If specific recommendations of accommodations are made, the rationale must relate the accommodation to the functional limitations imposed by the disability.
• What medication(s) does the student take for emotional/精神 health support? 服药后症状还会持续吗?
• 当前的神经心理学或心理评估报告可以让学生更彻底地适应.

需要的文档

文件必须由下列人士提供:

• 眼科医生;
• optometrist; or
• 其他持牌眼科护理专业人员.

所有文件必须在专业人士的官方信笺上提交，说明残疾情况. 报告应该注明日期, 签名并注明姓名, title, 以及评估人员的专业证书.

• 文件应包括诊断并说明最佳矫正视力和每只眼睛的视野程度. 包括诊断日期, 上次到访日期, 以及病情的严重程度, 以及治疗历史和治疗计划.
• 描述损伤对个人视觉能力的影响以及可能造成的功能限制. The impact should be discussed with particular detail 关于学术要求. 文件只包括诊断，图表 notes, 和/或处方便笺簿符号不足. 不提交手写文件.
• If specific recommendations of accommodations are made, the rationale must relate the accommodation to the functional limitations imposed by the disability.