Contact Information First Name * Last Name * Address Phone number (with area code) * Complaint Information Name of school(s) where you are currently enrolled and/or have attended in the past two years * Location of school(s) where you are currently enrolled and/or have attended in the past two years * How long have you been enrolled at the school(s) * Have you recently, within the last two years, experienced difficulties obtaining reasonable accommodations? * If yes please describe your request(s) for reasonable accommodations and the response(s) you received Have you recently, within the last two years, had a request for reasonable accommodations denied? * If yes, please describe the nature of the accommodation(s) requested and the reason, if any, provided for the denial If you answered yes to the question above, Please describe what effects the denial of accommodation had on your ability to learn and complete your coursework * (For Example - Were able to continue taking the class? Did you have to rely on outside assistance) Have you recently, within the last two years, experienced delays in the processing of reasonable accommodation requests? * If yes, please describe any effects the delay had on your ability to learn and complete your coursework. Please describe any alternative resources or methods, if any, that you used to cope with the delay in the processing of your reasonable accommodation request Have you ever made a complaint, whether formal or informal, regarding the denial of your reasonable accommodation request or a delay in processing your reasonable accommodation request? * What was the outcome, if any? Do you have documentation of these complaints? Do you have any documents regarding any of your reasonable accommodation requests and any denials or delays that followed? * Have you noticed any effects of the recent budget cuts to services for students with disabilities at your school(s)? * If yes, please describe Please provide any additional comments or information you think would assist our investigation *
