Disability Self-Assessment

* indicates a required field

Welcome!

Welcome to Accessibility Services. Please take some time to complete this form. This information, along with the medical documentation you provide, will help Okanagan College provide the best educational supports possible. Your responses in the Functional Limitations section give you the opportunity to speak about the barriers you face when in an educational setting. All information will be kept confidential and used only by your Accessibility Services Coordinator to inform your accommodations plan. If you have any questions about this form, please contact us at accessibility@okanagan.bc.ca

Preferred First Name

Last Name

Middle Name

Pronouns

Student No.

Enter your personal email address. This should be an address you check frequently since all Accessibility Services related communications will be sent to this email.

Phone Number

Program

Campus

Do you self-identify as an Indigenous person in Canada such as First Nation, Metis, or Inuit?

Diagnosed/Documented Disability

Check all that apply:

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If other disability, please indicate

Barriers or functional limitations impacting your studies. Please check all that apply.

Please provide any additional comments regarding your functional limitations:

Have you ever had academic accommodations before (in grade school, high school, post-secondary)?

Have you developed any strategies to help you manage any particular learning challenges?

Have you used assistive software and/or technology to offset the impact of the disability on your studies?

(e.g. Read & Write Gold, Kurzweil, Dragon Naturally Speaking, Zoom Text, etc.)

Have you used any assistive devices in the past (e.g. back support, an ergonomic chair, etc.)?

Does your program contain a practicum/clinical placement, work experience, service learning, or co-op?

Would you like more information or referrals relating to the following? (Check all that apply)

While at OC, do you prefer your meetings with the Accessibility Services Coordinator to be

Please read and agree to the statement below (includes Consent to Release Information):

Accessibility Services requests documentation of the student’s health condition /disability in order to establish eligibility and provide appropriate services.

Under the Canadian Charter of Rights and Freedoms individuals are protected from discrimination based on disability. Medical documentation is to verify that a disability and/or health condition exists, and there is impact on the student’s educational experiences.

The information you provide will be kept strictly confidential within the student’s file at Okanagan College’s Accessibility Services office ONLY and does NOT appear on any official OC records, test results, academic transcripts, or graduation documentation. By clicking the checkbox below, you are providing permission to release information to Okanagan College Accessibility Services, in accordance with the Freedom of Information and Protection of Privacy Act (FOIPPA).

Disclosure of a specific diagnosis is NOT required to access academic accommodations, services, and support. However, disclosure of a diagnosis or disability type is often useful to the professionals specifically trained in the provision of disability accommodations to better understand a student’s needs. There are certain circumstances where a diagnosis is required to establish eligibility for certain private (external) and federally or provincially funded supports and/or services.

I Understand that:

➢ It is my responsibility to provide accurate and timely documentation to OC Accessibility Services

➢ Requesting accommodations does not mean I have been or will be approved

➢ Retroactive accommodations will be considered on a case-by-case basis

➢ I must notify OC Accessibility Services if I add or drop a class

➢ I must notify OC Accessibility Services if my diagnosis changes or I receive a new diagnosis and I must provide updated documentation and meet with my Accessibility Services Coordinator

➢ I must contact my Accessibility Services Coordinator if I am having difficulties in securing or arranging accommodations

➢ Faculty are not required to provide accommodation(s) that fundamentally alter(s) the learning outcomes

➢ Failure on my part to carry out any of these responsibilities may result in my inability to secure accommodations

I give my consent for the release and/or exchange of confidential information during my studies at Okanagan College. This information is to be used by the Accessibility Services Coordinator to assist in my educational goals. I certify that my consent to release information is voluntary and that it can be revoked by me at any time in writing, but this will not affect the information collected under the prior consent. Non-identifying information will be kept for statistical purposes and will be provided to the Ministry of Advanced Education and Labour Market Development.

I have read, understood, and agree to the policies of Okanagan College Accessibility Services, and that you give permission for Okanagan College’s Accessibility Services to review your medical documentation and your Disability Self-Assessment form in preparation for your first meeting to determine eligibility for services.

Upload supporting document(s)

Please refer to this medical document table to confirm you are uploading the correct medical documents. In most cases you should upload either an OC Disability Verification Form -OR- a Psychoeducational Assessment completed by a certified medical professional. All documentation provided should be current. If you are unable to upload your documentation now, you may do so by dropping it off at any Student Services office, to any Coordinator directly, or by email. If you have further questions, please reach out to your local Accessibility Services Coordinator or accessibility@okanagan.bc.ca

Disability Self-Assessment

Welcome!

Document Information