UNE Special Needs Office Health Professional Report

HealthProfessionalReport

SPECIALNEEDSOFFICE

UniversityofNewEngland

C33LambleBuilding–WestWingArmidaleNSW2351

Phone:(02)67732897

Fax:(02)67734400

Email:

STUDENTDETAILS

FullName:StudentNumber:Course:

ThestudentneedstoattachthisreporttotheirUNESpecialNeedsRegistration.

TheSpecialNeedsOfficeprovidesadviceandassistancetostudentswhomayrequirereasonableadjustments1relatedtoadisabilityorotherhealthcondition,toenablethemtoparticipateinUNEstudiesonthesamebasisasotherstudents,whilstmaintainingtheacademicandotherinherentrequirementsofthecourse.

AlthoughstudentsdonothavetodisclosetheirdisabilityormedicalconditiontotheUniversity,studentsrequestingconsiderationandsupportonthebasisofadisabilityorhealthconditionarerequiredtoprovidetheUniversitywithrelevantmedicaldocumentationfromanaccreditedhealthprofessional.Thereasonsforthisrequirementare:

1.Tovalidatetheexistenceofthedisability,healthcondition.

2.ToprovidetheUniversitywithguidanceregardingtheeffectsofthedisabilityorhealthcondition

3.Toadviseofanyrecommendedadjustmentsthatwouldbeappropriateinminimisingitsimpactonstudy,accordingtothe2005DisabilityStandardsforEducation.

4.ToassisttheUniversitytocomplywiththeCommonwealthDisabilityDiscriminationAct(DDA)1992.

ThepersonalinformationprovidedwillbeprotectedinaccordancewiththeUNEPrivacyManagementRuleandwillbeusedbytheUniversitytoprovidereasonableadjustmentsandadvicetostudentsinrelationtoadisabilityorhealthcondition.

1Thisincludesadjustmentsfortheperson’scarer,assistantorassistanceanimal.

ACKNOWLEDGEMENTANDDISCLOSUREOFPERSONALINFORMATION

1.IherebyacknowledgeandagreethattheUniversityofNewEngland(UNE)maydiscloseinformationinmyhealthprofessionalreportorotherinformationthatIproviderelatingtomydisabilityand/orhealthcondition(s)to:

a.otherpartsoftheUniversity(includingunitorcourseco-ordinators)toassistwithidentifyingandprovidingreasonableadjustmentsformydisability;and

b.practicum,fieldandclinicalplacementproviders,toassistwithidentifyingandprovidingreasonableadjustmentsformydisabilitywhilstIundertakesuchactivities.

2.IalsoacknowledgeandagreethataSpecialNeedsAdvisermaycontactmymedicalpractitionerforclarificationorfurtherinformation,ifrequired.

3.Iacknowledgeandagreethattheprovisionofthisinformationisvoluntaryandifitisnotprovidedorisinadequate,theUniversitymaybeunabletoidentifyandimplementappropriateadjustments.

4.IacknowledgeandagreethatIwillprovideupdatedmedicalinformationuponreasonablerequestbytheSpecialNeedsOfficeorifmymedicalcircumstanceschange.IacknowledgeandagreethatifIdonotrespondwithintherequestedtimeframestosuchrequests,theUniversitymaynotbeabletoidentifyorprovidereasonableadjustmentsinatimelymanner.

5.TheSpecialNeedsOfficeunderstandstheoftensensitivenatureoftheinformationthatmaybedisclosedtoitandrespectstheprivacyofthatinformation.Iacknowledgethatthepersonal

informationprovidedinrelationtomyregistrationwiththeSpecialNeedsOfficewillbecollected,used,.

Signed:Date:

THEFOLLOWINGSECTIONSARETOBECOMPLETEDBYANACCREDITEDHEALTHPRACTITIONER:

IdeclarethatIamnotacloserelativeorassociateofthisstudent(i.e.partner,spouse,child,sibling,parent,extendedfamilymember,neighbour,partnerofchildorcolleague).

NameofPractitioner:ProviderNumber:Profession: Phone:

Email:Signature:

TobecompletedbyanaccreditedhealthprofessionalONLY

Practitioner’sStamp

Disability/HealthConditionInformation

Diagnosis:

Briefdescriptionofcondition/s:

DisabilityType(tickallthatapply)

HearingVisionPhysicalMentalHealthLearningChronicIllnessordisease Neurological(e.g.AutismSpectrumDisorder)

Prognosis

Thestudent’sconditionisexpectedtoresolve/improve/bewellmanagedwithin

3months6months12monthsor

Thestudent’sconditionisongoing(thisincludesconditionsthatarestable,fluctuatingordegenerative)Howlonghaveyoubeentreatingthisstudent?

OnlineLearning

UNEteachesinoralandwrittenEnglish.Mostteachingmaterialsareprovidedtostudentsusinganonlinesystemandstudentsarerequiredtohaveaccesstoacomputerandtheinternet.

Doesthestudent’sdisability/healthconditionimpactontheirparticipationinonlineteachingenvironmentsviaprovisionofonlineteachingmaterialsorinteractioninonlinediscussionsorother?

NoYes

If‘yes’,pleasecommentonthelimitationsbasedonthestudent’sdisability:

Lectures,Tutorials,IntensiveSchools,WorkshopsFieldwork

Participationinlectures,tutorials,intensiveschools,workshopsandfieldworkisarequirementforsomeUNEcourses.

Doesthestudent’sdisability/healthconditionimpactontheirabilitytoaccessand/orparticipateinlectures,tutorials,intensiveschools,workshopsfieldwork?

Ifso,pleaseprovidedetails:

LearningMaterial-Hardcopy

Doesthestudent’sdisability/healthconditionpreventthemfromusingtextbooksandotherhardcopiesofstudymaterial?

NoYes

If‘yes’,pleaseprovidedetails:

TheUNESpecialNeedsOfficemayprovidethestudentwithelectroniccopiesoftheirstudymaterial.ThisisprovidedinPDFformat,unlessanotherformatisrequested.

Doesthestudentuseassistivetechnology,suchas‘DragonNaturallySpeaking’,‘ReadWriteGold’etc?

NoYesPleasespecify:

StudentsareexpectedtohavedevelopedtheskillsinusingtheirtechnologybeforecommencingtheirstudiesatUNE.

LearningMaterial-Aural

Doesthestudenthaveahearingimpairmentthatpreventsthemfromhearingauralmaterial?

NoYes

If‘yes,onlineauralmaterial(podcastsetc)maybetranscribedandprovidedtothestudentinMSWordformat.

If‘yes’aboveandattendinglectures,whichreasonableadjustmentsaremostappropriateforthestudent:

(tickallthatapply)

Instantcaptioning(studentwillneedtohavealaptopcapableofdisplayinginstantcaptioning)T-Loopinlecturetheatres

StaffandotherstudentsfacingstudentwhenspeakingtothemElectroniccopiesoflectureslidesandnotes

OtherPleasespecify:

Assessments

Doesthestudent’sdisability/healthconditionimpactontheirabilitytocompleteonlineassessments,includingtimedassessments?

NoYes

If‘yes’,pleasecommentonthelimitationsbasedonthestudent’sdisability:

Doesthestudent’sdisability/healthconditionpreventthemfromsubmittingassignmentswithintherequiredtimeframes?

NoYes

If‘yes’,pleasecommentonthelimitationsbasedonthestudent’sdisability:

Doesthestudent’sdisability/healthconditionpreventthemfromundertakinginvigilatedexaminations?

Pleasenotethatinvigilatedexaminationsarearequirementforsomeunits.

NoYes

If‘Yes',pleasecommentonthelimitationsbasedonthestudent’sdisability:

Doesthestudentrequireadjustmentsduringinvigilatedexaminations?
Extratimetocompleteand/orhaverestbreaks(includingtomovearoundetc) / No / Yes
Separateroomorsmallgroup / No / Yes
Levelaccesstoexaminationvenue / No / Yes
Useofowncomputer / No / Yes
Useofownassistivetechnology / No / Yes
Useofownergonomicfurniture / No / Yes
Reader / No / Yes
Scribe / No / Yes
Seatedclosetotoilets / No / Yes
Permissiontoadministermedication/checkinsulinlevels / No / Yes
Enlargedexaminationpaper / No / Yes
Colouredexaminationpaper / No / Yes
IfYes,whatcolour

ProfessionalExperience/Workplacements

Professionalexperienceisarequirementforsomecourses.

Doesthestudent’sdisability/healthconditionhaveanimpactonthemcompletingprofessionalexperience/workplacements?

NoYesN/A

If‘yes’,pleasecommentonthelimitationsbasedonthestudent’sdisability:

Arethereanyadjustmentsthatmayassistthestudentincompletingtheirprofessionalexperience/workplacement?

ThestudentwillneedtodiscussspecificadjustmentswiththeirProfessionalExperience/PlacementCoordinator.

HealthManagementPlan

Doesthisstudentrequireahealthmanagementplan,incasethestudentexperiencesanadversehealthreactiononcampusorduringinvigilatedexaminations?

NoYes

Ifyes,couldyoupleasefilloutaHealthManagementPlanontheformoverpage.

AdditionalInformation

Pleaseprovideanyadditionalinformationthatmayassistthestudentinsucceedingintheirstudies:

Thankyouforyourassistanceinprovidingthisdocumentation.ThiswillgreatlyassisttheUNESpecialNeedsOfficeinassessingandnegotiatingreasonableadjustmentsforthisstudenttoallowtheirequalparticipationatUNE.

UNEStudentHealthManagementPlan

SPECIALNEEDSOFFICE

UniversityofNewEngland

C33LambleBuilding–WestWingArmidaleNSW2351

Phone:(02)67732897

Fax:(02)67734400

Email:

Thisdocumentistobecompletedbyanaccreditedhealthprofessional,ifastudenthasahealthcondition,whichmayrequireaHealthManagementPlan.Thisinformationwillbekeptonthestudent’sfileattheSpecialNeedsOffice,sothatwehavethisinformation,shouldwebecomeawareofanincident.

Itisthestudent’sresponsibilitytoprovideacopyofthisStudentHealthManagementPlantounitcoordinators,examsupervisors,lecturers,professionalplacementcoordinatorsandotherappropriatestaff,priortoeachsession,asrequired,toensurethestudentcanbesupportedappropriatelyintheeventofanadversehealthreaction.ThestudentmayalsoprovidethisPlantothirdpartiessuchaspracticum,fieldandclinicalplacementproviders.

PleaserefertotheprivacyinformationonthefrontoftheHealthProfessionalReport.TheinformationprovidedinthisHealthManagementPlanmaybesharedwithexternalprovidersonlytomeetOH&Srequirements.

StudentName:

StudentNumber:

Courseenrolled:

HealthCondition/s(optional):

Symptomsastudentmaybeexperiencingduringanadversehealthreaction:

Student’sself-managementorprophylacticmeasurestoavertthereaction:

Whatstaff/fellowstudentsshoulddo:

Whatstaff/fellowstudentsshouldNOTdo:

SignatureofhealthprofessionalprovidingthisHealthManagementPlan.Professional’sName:

Professional’sSignature:Date: