Office of Disability Services
620/341-6637 V; 620/341-6646 TTY
www.emporia.edu/disability

EVALUATION

1. What types of services have you requested from the office?
a. Accommodation Letter ___
b. Academic Accommodations ___
c. Academic Assistance ___
d. Activity Accommodations ___
e . Access Accommodations ___
f . Completion of Certifications for PPST/CAAP ___
g . None ___
h . Other (Please list) ________________________________________________________________________

1. When did you register with the office? (Please circle)
Before coming to ESU
1st Year
2nd Year
3rd Year
4th Year
5th Year
6th Year

2. If you sought information prior to attending ESU, how would you rate the services? (Please circle)
<Not Applicable > <Exceeded> <Mostly Met> <Met the Need> <Met Somewhat> <Didn't Meet>

3. How would you rate the office in meeting your disability service needs? (Please circle)
<Exceeds> <Regularly Meets> <Usually Meets> <Sometimes Meets> <Doesn't’t Meet>

4. Do you find the office to be physically accessible? Yes No (Please Circle) Areas of improvement may include: _____________________________________________________________

5.. Do you find the office to be accessible to those with hidden disabilities? Yes No (Please Circle)
Areas of improvement may include:________ _________________________________

6 . Do you find the campus to be physically accessible? Yes No (Please Circle) Areas of improvement may include: ______________________________________________

7 . Do you find the campus to be accessible to those with hidden disabilities? Yes No (Please Circle) Areas of improvement may include:________ _________________________________

8 . What types of adaptive technology would you find to be useful? __________________________
_____________________________________________________________________________

9 . How would you rate the services from the office, using the following rating scale?<1=Have Not Requested> <2=Very Useful> <3=Useful> <4=Somewhat Useful> <5=Not Useful>
Academic Accommodations ___
Campus Resources ___
Activity Accommodations ___
Working with Faculty ___
Referral Information ___
Working with Staff ___
Community Resources ___
Creating Awareness of Disability Related Issues ___
Assistance with Self-Advocacy ___
Web site ___

10 . Are you interested in participating in programming activities for people with disabilities? Yes ___ No ___ If so, what type? ________________________________________________________________

11 . Are you interested in internship and scholarship opportunities marketed specifically to students with disabilities? Yes ___ No ___

12 . Where do you believe there to be the greatest need at ESU for information about equal access for people with disabilities?

Please use the following rating scale for the remaining questions:
0=Does not Apply; 1 = Always; 2 = Almost Always; 3 = Usually; 4 = Sometimes; 5 = Never
Does the office staff:
1. Advocate on behalf of students with disabilities to the campus ___
2. To the community ___
3. Assure that students have access to the programs and activities offered by ESU ___
4 . Facilitate and coordinate accommodations and services in a timely fashion ___
5. Post scholarship opportunities that are external to the institution ___
6. Operate on an equitable basis ___
7. Provide clear expectations of the office’s responsibility ___
8. Provide clear expectations of student responsibility ___
9. Provide clear expectations of faculty responsibility ___
10. Respond appropriately when ESU equipment dysfunctions ___
11. Encourage you to plan ahead for course registration ___
How would you rate the student staff within the office in the following areas:
12. Responsiveness and professionalism in working with you ___
13. Answers the phone and responds to your questions politely and appropriately ___
14. Are respectful and courteous ___
15. When serving as a reader for exams, does so appropriately ___
16. When serving as a scribe for exams, does so appropriately ___
17. Are knowledgeable about office practices ___
18. Will refer to you the director if unsure or appropriate ___

DEMOGRAPHIC INFORMATION

1. What type of disability (ies) do you have?
2. Learning Disability ___
3. ADD/ADHD ___
4. Visual Impairment ___
5. Hearing Impairment ___
6. Chronic Health ___
7. Psychological Impairment ___
8. Mobility Impairment ___
9. Other __________________
10. Have you submitted documentation of each disability to the office? Yes ___ No ___
11.Are you an undergraduate or graduate? (Please Circle)
12. What year are you? 1st Year ___ 2nd Year ___ 3rd Year ___ 4th Year ___
13. Are you a client of a state agency that provides assistance to people with disabilities?
Yes ___ No ___
14. What state are you from? _________
15. What is the year of your birth? __________
16. What is your major? _________
17. What is your minor? _________
18.Do you live on-campus? Yes ___ No ___

Please use the space below for any additional suggestions or comments. Feel free to attach additional pages.

DS/2003-04 Assessment

 

You will need to print this off and either drop off at the office or mail to Office of Disability Services 1200 Commercial St. Box 4023, Emporia KS 66801.

If you need accommodations to participate in the survey, please make requests to the director of the Office of Disability Services at 620/341-6637;V 6646 TTY or email petersmi@emporia.edu

 

Last Updated March 22, 2007