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Eastern Illinois UniversityOffice of Student Disability Services Initial Intake Form Number: E Today's Date: Name: OPTIONAL: Birth Date: Campus Address: Cell Phone: Campus Phone: Email Address: as.
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How to fill out disability services intake

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How to fill out disability services intake form

01
To fill out a disability services intake form, follow these steps: 1. Start by providing your personal information, such as your name, contact details, and student ID if applicable.
02
Indicate the type of disability you have or the services you are seeking.
03
Answer any questions regarding your specific disability or medical history. Be honest and provide as much detail as possible to help the service provider understand your needs.
04
If applicable, include information about any accommodations or support services you have previously received or are currently using.
05
Provide any relevant documentation, such as medical reports or assessments, to support your disability claim or request for services.
06
If there are any specific goals or objectives you have regarding the services you are seeking, outline them clearly in the form.
07
Review the completed form to ensure all information is accurate and complete.
08
Sign and date the form to acknowledge that the information provided is true and accurate.
09
Submit the form to the designated disability services office or department. Follow any additional instructions provided.
10
Keep a copy of the completed form for your records.

Who needs disability services intake form?

01
Anyone who requires disability services or accommodations due to a physical, cognitive, psychological, or sensory impairment may need to fill out a disability services intake form.
02
This includes students with disabilities, employees seeking workplace accommodations, individuals seeking government assistance or benefits, and anyone requiring support services to help them access education, employment, healthcare, or other essential services.

What is Disability Services Intake - eiu.edu Form?

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Disability Services Intake - eiu.edu template instructions

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The disability services intake form is a document used to gather information about individuals with disabilities to determine their eligibility for services and support.
Individuals seeking assistance or services related to their disabilities are required to file the disability services intake form.
To fill out the disability services intake form, individuals should accurately complete all required fields, provide relevant personal and medical information, and submit any necessary documentation as specified.
The purpose of the disability services intake form is to collect relevant information to assess an individual's needs and eligibility for disability-related services and supports.
The information usually required includes personal identification details, description of the disability, medical history, and any previous services received.
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