Forms

You may pick up forms in the Office of Disability Services, HO-105, or in the Support Lab, HO-114, both located at the Albany Main Campus.  Other locations include: the Benton Center, BC-222 or the Lebanon Center, front desk. 

To have forms mailed to you, please contact Nancy Tanberg at 541-917-4789 or by email at ods@linnbenton.edu.

These forms require you to have a recent version of Adobe Acrobat Reader® installed. Download Adobe Acrobat

Heads up For Service Form

Disability Services Brochure

Intake Form -- Getting Started

(PDF)

(PDF)

(PDF)

 

 (Microsoft Word)

(Microsoft Word)

(Microsoft Word)

Consent to Share Information Form -- Confidentiality, our #1 priority.

(PDF)

 

(Microsoft Word)

Release of Documentation Form -- Obtaining the documents needed.

(PDF)

 

(Microsoft Word)

What Kinds of Documentation

 

 

 

Alternative Format Request Form 

Notetakers Brochure (information for the person taking notes in the classroom)

Disclosure of Information Form -- Sending information to another institute  

(PDF) 

(PDF)

(PDF)

 

(Microsoft Word) 

 (Microsoft Word)

(Microsoft Word)

 

 

 

Interpreting Forms

Letter Model to Instructors--Weekend Classes & Early Contact   (PDF)     (Microsoft Word)