Exchange of Information
In order to explore possible reasonable accommodations, it is often necessary for Services for Students with Disabilities to discuss the documentation the student has submitted to our office (DARF, Medical Verification forms, diagnosis, personal requests/statements) with providers such as licensed physicians, psychologists or other qualified professionals, and to discuss the student’s impairment with their parents and University of Indianapolis faculty, professional staff, and institution officials. I hereby give permission for members of the staff of Services for Students with Disabilities, to exchange information regarding the documentation I have submitted to the Services for Students with Disabilities office with my provider(s) (physician, psychologist, or other qualified professional), and to discuss my disability with my parents and University of Indianapolis faculty, professional staff and institution officials. This authorization will remain in effect for the duration of my enrollment at UIndy. I understand that I may revoke this release of information privilege at any time by informing the Services for Students with Disabilities. I understand that this information is desired in order to assist those who are helping with my education and my request for accommodation, and that my refusal to authorize consent may result in a denial of specific accommodations. I also understand that my disability documentation will be kept on file for five years and that I should keep a copy of any records pertaining to my disability.
