DSPS Forms and Information

• Application Packet for DSPS Services  Fill out and print this packet to bring with you to your Intake Appointment.
• Access & Opportunity Brochure  This brochure will provide general information about our services.
• Disability Verification Form  Print this form to take to your doctor or other health professional that can verify and document your disability.
• Consent to Release Information  Fill out and submit this form to our office if you want to request that we send information to another college or if you want us to share information about you with instructors or other individuals you name specifically.
• K-12 to College Transition Information  This information will help explain the differences between how the K-12 system provides accommodation services and how accommodation services are provided at the community college.
• Steps to Enrollment This check list will help ensure you have completed all the steps needed to get enrolled at Butte College and register for services with our program.
• Courtesy Cart Reservation Form Eligible students need to make a reservation for the courtesy cart using this form at least 1 business day in advance.
• Alternate Media Request Form Fill out this form if you are authorized Alternate Media services.

What Do I Need for my DSPS Appointment?

Student is responsible for providing appropriate documentation that:

• Verifies class enrollment (class schedule)
• Verifies disability (copy(s) of documentation)
• Identifies major life activities that are impaired
• If you are under 18 years of age, a parent or legal guardian must be present at your appointment

PLEASE PROVIDE STUDENT ID#

For Information Contact:
Phone Numbers: Voice (530) 895·2455 TTY (530) 895·2308 FAX (530) 895·2235