Accuplacer Accommodations Application
Students must first be approved to take the Accuplacer at SAGU before beginning this process.
Name
*
First Name
Last Name
Email
*
Date of Birth
*
List your primary language if not English
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Professional Disability Documentation Requirements
Students are responsible for gathering and submitting clinical documentation. Read the information below carefully, and be sure to have your disability documents ready to attach to this application.
Qualification Guidelines for Documentation
Themes that Professional Documentation Must Address
Diagnosis
Assessment
- methods, results, and interpretation
Symptoms
- characteristics, severity, duration, frequency, triggers, etc.
Effects/Supports
- recommended accommodations, strengths-weaknesses, symptoms' effect on academics, recommendations, academic limitations of student, accommodations history, etc.
Validation of Professional Documentation
Written on
Official Letterhead
Includes
Professional Credentials
Physical Signature
of Professional
Nerocognitive tests mus cover the following domains
Complex attention
Executive function
Learning and memory
Language
Perceptual-motor
Social cognition
Age of Professional Documentation
No more than 3 years old
- Neurocognitive Tests
No more than 5 years old
- Intelligence Tests, Achievement/Aptitude tests, Clinical Tests, Personality Tests, Behavioral Tests, Psycho-educational Evaluations
No more than 1 month from the accommodation request date
- Physician and Therapist Letters
Types of Clinical Documentation
Full and Independent Evaluation (FIE - Texas)/Independent Educational Evaluation (IEE) - report of diagnosis, psychological/cognitive assessment and evaluation results from school district
Psycho-educational Evaluation (Must use in-depth tests and not screens)
Psychological/Psychiatric Evaluation and Diagnosis Reports (Supported with testing results administered by a qualified professional)
Physician's/Therapist's Letter
Types of Supplementary Documentation from Academic Institutions - These documents are helpful but do not contain all of the information required.
Individualized Education Plans (IEPs) can provide a list of recommended accommodations but will not serve as official diagnosis documentation. An FIE/IEE will be needed (See "Types of Clinical Documentation" above)
504 Plans - If the student received accommodations or was identified as disabled under section 504, the high school counselor should have copies or be able to have copies sent to the student or to the Academic Accommodations Office.
Admission, Review, and Dismissal (Exit ARD) Reports/ Summary of Performance (SOP) - school district disability document providing overview of interventions, accommodations, and performance throughout primary and secondary grades. This will not serve as official diagnosis documentation. An FIE/IEE will be needed (See "Types of Clinical Documentation" above)
Submit disability documentation here.
*
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Medical/Mental Health Background
List the disabilities that are affecting your studies.
Disability 1
*
Effect of Disability 1 on Academics
*
Disability 2
Effect of Disability 2 on Academics
Disability 3
Effect of Disability 3 on Academics
Disability 4
Effect of Disability 4 on Academics
Disability 5
Effect of Disability 5 on Academics
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Academic Accommodations History
Review the following accommodations, and check all that apply.
Use of Calculator
*
Effective in past
May help
Spelling/Grammar Help
*
Effective in past
May help
Extra Time on Exams
*
Effective in past
May help
Scribe on Exams
*
Effective in past
May help
Use of Voice to Text
*
Effective in past
May help
Exams in a Quiet Place
*
Effective in past
May help
Other
List and explain any other accommodations here that were not listed above but have been helpful to you in the past.
List your academic strengths
*
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