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    		Office of Student Disabilities Services
    Satisfaction Survey Form
    Which professional staff member was your primary contact?
    With which disability/disabilities have you been diagnosed?
    ADHD
    Chronic Medical Condition
    Hearing Impaired
    Learning Disability
    Mobility Impaired
    Psychological
    Visual Impairment
    Other, please explain below.
    What, if any, accommodations did you use on exams?
    Extended Time
    Scribe
    Proctor
    Alternate Exam Site
    Enlarge/Bold Exams
    Lap top use
    Use of CCTV

    Other, please explain below.
    What accommodations did you use in the classroom?
    Audio Tape Recorded Lectures
    Enlarged Print Materials and Handouts
    What auxiliary services did you use?
    CART Sign Language Interpreter
    Notetaker Books on Tape
    Typist Library Assistant
    Reader Penn Accessible Transit (PAT)
    Proctor Assistive Technology
    What type of assistive technology?

     

    How much do you agree with the following questions:

    Strongly Disagree

    1

    Somewhat Disagree

    2

    Neutral

    3

     

    Agree

    4

    Strongly
    Agree

    5
    1) Professional staff were responsive to my needs. (1-5)
    2) Professional staff were available and willing to help in a timely manner. (1-5)
    3) Professional staff clearly explained policies and procedures. (1-5)
    4) Professional staff clearly explained the need for comprehensive documentation. (1-5)
    5) The staff helped me reach agreement on academic adjustments. (1-5)
    6) Exam accommodations were arranged in a timely and effective manner. (1-5)
    7) Auxiliary services were arranged in a timely and effective manner. (1-5)
    8) Staff helpfully intervened on my behalf with faculty or staff as needed and upon my request. (1-5)

    Overall, how would you rank Student Disabilities Services (SDS)

    (1-5)

    What, if anything, did you find most helpful

    What, if anything, did you find not helpful

    What suggestions do you have for SDS to help meet you needs more effectively

    Additional Comments (optional):


     

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