Disability Services must receive this form and appropriate documentation of your disability to support requested accommodations prior to consideration and provision or approval of accommodations. Once documentation is receive and reviewed, the applicant will need to meet with Disability Services office staff to discuss accommodations, procedures, and policies. Information regarding disability is kept in Disability Services and is considered an academic record but is no noted in any way on the student's transcript.
I, the undersigned James Madison University student, give permission to the professional staff at the Disability Services Office to discuss issues and release information relevant to my disability and my access to the services, programs and courses at JMU with appropriate University officials, faculty, and staff. I understand that this primarily relates to information necessary to determine and provide appropriate and reasonable accommodations, if such accommodations are requested, and information provided to employees with a legitimate need to know, and that I will be advised prior to other consultations or disclosures of information. I also understand that the Disability Services staff are responsible employees and mandated reporters, and are required to report any information that indicates past or present child abuse (under University Policy 1406), past or present sexual abuse or misconduct (under University Policy 1340), past or present fraud (under University Policy 1603) or potential intent of harming yourself or others, among other instances constituting an emergency (under University Policy 2112).
I understand that my consent to release this information will remain in effect for the duration of my enrollment at JMU and that I may withdraw this consent in writing. Please note that ODS will exchange information with other relevant authorities on campus to evaluate and facilitate the provision of accommodations. Permission is granted to ODS to exchange information with the clinician listed below as necessary to answer questions about the documentations submitted to support this request and in consideration of my application for accommodations.