Documentation Guidelines for
Attention Deficit Disorder
and/or
Attention Deficit/Hyperactivity Disorder
Any student requesting accommodation services from Kirkwood Community College is
required to submit an application for services and documentation of the disability to verify
eligibility under the Americans with Disabilities Act (ADA); Section 504 of the Rehabilitation
Act of 1973; and Kirkwood’s policies. ADA defines a disability as a substantial limitation of
major life function. The diagnostic report must document a disability. Reasonable
accommodations cannot be implemented until the student's documentation is complete. An
IEP or 504 Plan may be sufficient documentation if it addresses all points listed below.
The documentation must be germane to the student’s stated disability and be signed by a
psychologist, learning disability specialist, special education consultant, or other professional
not related to the student. Documentation should include the evaluator’s name, title,
professional credentials, address, phone number, and fax number and the date of the report.
The documentation should be submitted on official letterhead including your signature.
(Prescription pad notations will not be sufficient):
1. A clear statement of the diagnosis;
2. Documentation for eligibility should be current, preferably within the last three years
(the age of acceptable documentation is dependent upon the disabling condition, the
current status of the student and the type of accommodation requested by the student);
3. A summary of assessment procedures and evaluation instruments used to make the
diagnosis, including evaluation results and standardized scores. The documentation
should include the student’s history and demonstrated manifestations of the ADD or
ADHD in more than one setting, including academic performance.
4. A description of present functioning which provides evidence of ongoing
impulsive/hyperactive or inattentive behavior that has impaired functioning over time;
5. Information relating to the student's needs should include the impact of the disability
and/or the medication(s) on the student's ability to meet the demands of the
postsecondary environment;
6. Specific suggestions of reasonable accommodations which might be appropriate at the
postsecondary level are encouraged. These recommendations should be supported by
the diagnosis and assessment.
All documentation is confidential and should be submitted to:
Kirkwood Community College
6301 Kirkwood Blvd SW
Learning Services – Cedar Hall 2063
Cedar Rapids IA 52404
(319) 398-5574 Phone
(319) 398-4933 FAX
11/1/08
Documentation Guidelines
for
Learning Disability and Mental Disability
Any student requesting accommodation services from Kirkwood Community College is
required to submit an application for services and documentation of the disability to verify
eligibility under the Americans with Disabilities Act (ADA); Section 504 of the Rehabilitation
Act of 1973; and Kirkwood’s policies. ADA defines a disability as a substantial limitation of
major life function. The diagnostic report must document a disability. Reasonable
accommodations cannot be implemented until the student's documentation is complete. An
IEP or 504 Plan may be sufficient documentation if it addresses all points listed below.
The documentation must be germane to the student’s stated disability and be signed by a
psychologist, learning disability specialist, special education consultant, or other professional
not related to the student. Documentation should include the evaluator’s name, title,
professional credentials, address, phone number, and fax number and the date of the report.
The documentation should be submitted on official letterhead including your signature.
(Prescription pad notations will not be sufficient):
1. A clear statement of the diagnosis which specifies the type of learning disability/mental
disability;
2. Documentation for eligibility should be current, preferably within the last three years
(the age of acceptable documentation is dependent upon the disabling condition, the
current status of the student and the type of accommodation requested by the student);
3. A summary of assessment procedures and evaluation instruments used to make the
diagnosis, including evaluation results and standardized scores. Performance on
assessments such as: WAIS-III, Woodcock Johnson (cognitive, reading, math),
Stanford-Binet, Kaufman Intelligence Test, Test of Written Language (TOWL), and other
similar assessment instruments should be reported;
4. A description of present functioning which meets the criteria for diagnosis;
5. Information relating to the student's needs should include the impact of the disability
and/or the medication(s) on the student's ability to meet the demands of the
postsecondary environment;
6. Specific suggestions of reasonable accommodations which might be appropriate at the
postsecondary level are encouraged. These recommendations should be supported by
the diagnosis and assessment.
All documentation is confidential and should be submitted to:
Kirkwood Community College
6301 Kirkwood Blvd SW
Learning Services – Cedar Hall 2063
Cedar Rapids IA 52404
(319) 398-5574 Phone
(319) 398-4933 FAX
11/1/08
Documentation Guidelines for
Psychiatric/Psychological Disabilities
(Includes but is not limited to: Depressive Disorders, Post-Traumatic Stress Disorder, Bipolar
Disorders, and Disassociative Disorders)
Any student requesting accommodation services from Kirkwood Community College is
required to submit an application for services and documentation of the disability to verify
eligibility under the Americans with Disabilities Act (ADA); Section 504 of the Rehabilitation
Act of 1973; and Kirkwood’s policies. ADA defines a disability as a substantial limitation of
major life function. The diagnostic report must document a disability. Reasonable
accommodations cannot be implemented until the student's documentation is complete.
The documentation must be germane to the student’s stated disability and be signed by
a physician, psychiatrist, psychologist, or other professional not related to the student.
Documentation should include the evaluator’s name, title, professional credentials, address,
phone number, and fax number and the date of the report.
The documentation should be submitted on official letterhead including your signature.
(Prescription pad notations will not be sufficient):
1. A clear statement of the disability, including the DSM-IV diagnosis and a summary
of present symptoms;
2. Documentation for eligibility should be current, preferably within the last three years
(the age of acceptable documentation is dependent upon the disabling condition, the
current status of the student and the type of accommodation requested by the student);
3. A summary of assessment procedures and evaluation instruments used to make
the diagnosis and a summary of evaluation results, including standardized and
percentile scores;
4. A description of present symptoms which meet the criteria for diagnosis;
5. Medical information relating to the student's needs should include the impact of the
disability and/or medication(s) on the student's ability to meet the demands of the
postsecondary environment;
6. Suggestions of reasonable accommodations which might be appropriate at the
postsecondary level are encouraged. These recommendations should be supported
by the diagnosis.
All documentation is confidential and should be submitted to:
Kirkwood Community College
6301 Kirkwood Blvd SW
Learning Services – Cedar Hall 2063
Cedar Rapids IA 52404
(319) 398-5574 Phone
(319) 398-4933 FAX
11/1/08
Documentation Guidelines for
Physical Disabilities and Systemic Illnesses
(Includes but is not limited to: Mobility Impairments, Multiple Sclerosis, Cerebral Palsy,
Chemical Sensitivities, Spinal Cord injuries, Cancer, AIDS, Muscular Dystrophy, Spina
Bifida, etc.)
Any student requesting accommodation services from Kirkwood Community College is
required to submit an application for services and documentation of the disability to verify
eligibility under the Americans with Disabilities Act (ADA); Section 504 of the Rehabilitation
Act of 1973; and Kirkwood’s policies. ADA defines a disability as a substantial limitation
of major life function. The diagnostic report must document a disability. Reasonable
accommodations cannot be implemented until the student's documentation is complete.
The documentation must be germane to the student’s stated disability and be signed by
a physician, neurologist, psychiatrist, psychologist, or other professional not related to the
student. Documentation should include the evaluator’s name, title, professional credentials,
address, phone number, and fax number and the date of the report.
The documentation should be submitted on official letterhead including your signature.
(Prescription pad notations will not be sufficient):
1. A clear statement of the medical diagnosis of the physical disability or systemic
illness;
2. Documentation for eligibility should be current, preferably within the last three years
(the age of acceptable documentation is dependent upon the disabling condition, the
current status of the student and the type of accommodation requested by the student);
3. A summary of assessment procedures and evaluation instruments used to make
the diagnosis;
4. A description of present symptoms which meet the criteria for diagnosis;
5. Medical information relating to the student's needs should include the impact of the
disability and/or medication(s) on the student's ability to meet the demands of the
postsecondary environment;
6. Suggestions of reasonable accommodations which might be appropriate at the
postsecondary level are encouraged. These recommendations should be supported
by the diagnosis.
All documentation is confidential and should be submitted to:
Kirkwood Community College
6301 Kirkwood Blvd SW
Learning Services – Cedar Hall 2063
Cedar Rapids IA 52404
(319) 398-5574 Phone
(319) 398-4933 FAX
11/1/08
Documentation Guidelines
for
Deaf/Hard of Hearing
Any student requesting accommodation services from Kirkwood Community College is
required to submit an application for services and documentation of the disability to verify
eligibility under the Americans with Disabilities Act (ADA); Section 504 of the Rehabilitation
Act of 1973; and Kirkwood’s policies. ADA defines a disability as a substantial limitation
of major life function. The diagnostic report must document a disability. Reasonable
accommodations cannot be implemented until the student's documentation is complete.
The documentation must be germane to the student’s stated disability and be signed by
a physician, otorhinolaryngologist, otologist, audiologist, or other professional not related to
the student. Documentation should include the evaluator’s name, title, professional
credentials, address, phone number, and fax number and the date of the report.
The documentation should be submitted on official letterhead including your signature.
(Prescription pad notations will not be sufficient):
1. A clear statement of deafness or hearing loss, with a current audiogram within the
last three years (the age of acceptable documentation is dependent upon the condition,
the current status of the student, and the student's request for accommodations);
2. A summary of assessment procedures and evaluation instruments used to make the
diagnosis and a narrative summary of the results, if appropriate;
3. Medical information relating to the student's needs and the status of the individual's
hearing (static or changing) and its impact on the demands of the academic program;
4. A statement regarding the use of hearing aids or cochlear implants (if appropriate)
5. Suggestions of reasonable accommodations which might be appropriate at the
postsecondary level are encouraged. These recommendations should be supported
by the diagnosis.
All documentation is confidential and should be submitted to:
Kirkwood Community College
6301 Kirkwood Blvd SW
Learning Services – Cedar Hall 2063
Cedar Rapids IA 52404
(319) 398-5574 Phone
(319) 398-4933 FAX
11/1/08
Documentation Guidelines
for
Blind/Low Vision
Any student requesting accommodation services from Kirkwood Community College is
required to submit an application for services and documentation of the disability to verify
eligibility under the Americans with Disabilities Act (ADA); Section 504 of the Rehabilitation
Act of 1973; and Kirkwood’s policies. ADA defines a disability as a substantial limitation
of major life function. The diagnostic report must document a disability. Reasonable
accommodations cannot be implemented until the student's documentation is complete.
The documentation must be germane to the student’s stated disability and be signed by
a physician, opthamologist, optometrist, or other professional not related to the student.
Documentation should include the evaluator’s name, title, professional credentials, address,
phone number, and fax number and the date of the report.
The documentation should be submitted on official letterhead including your signature.
(Prescription pad notations will not be sufficient):
1. A clear statement of a visual disability with supporting data.
2. Documentation for eligibility should be current, preferably within the last three years
(the age of acceptable documentation is dependent upon the disabling condition, the
current status of the student and the student's specific request for accommodations);
3. A summary of present symptoms which meet the criteria for diagnosis of a visual
disability.
4. Medical information relating to the student's needs and the status of the student's
vision (static or changing) and its impact on the demands of the academic program.
5. Narrative or descriptive text providing both quantitative and qualitative information
about the student's abilities which might be helpful in understanding the student's
profile, including the use of corrective lenses and ongoing visual therapy (if appropriate).
6. Suggestions of reasonable accommodations which might be appropriate at the
post-secondary level are encouraged. These recommendations should be supported by
the diagnosis.
All documentation is confidential and should be submitted to:
Kirkwood Community College
6301 Kirkwood Blvd SW
Learning Services – Cedar Hall 2063
Cedar Rapids IA 52404
(319) 398-5574 Phone
(319) 398-4933 FAX
11/1/08