Service and Assistance Animal in Housing Packet

Transcription

1 Service and Assistance Animal in Housing Packet This packet includes these forms Service and Assistance Animal Policy...page 2-8 Service and Assistance Animal Registration Form...page 9-10 Service and Assistance Animal Roommate Agreement...page 11 Assistance Animal Verification Form...page Submit your completed form via one of the listed methods o Scan and to housing@morningside.edu o Fax to o Mail to Morningside College, Residence Life, 1501 Morningside Ave, Sioux City, IA, o Turn in on campus in the Residence Life Office located on the lower level of the Olsen Student Center. Watch your Morningside or the address you listed in the forms for the status of your accommodation request. For more information on Morningside College Accommodations visit these websites Housing Accommodations: my.morningside.edu/housingacc Disability Services: The Morningside College experience cultivates a passion for life-long learning and a dedication to ethical leadership and civic responsibility.

2 RESIDENCE HALL SERVICE AND ASSISTANCE ANIMAL POLICY I. Purpose of the Policy Animals, including pets, other than fish in a 10-gallon tank, are not permitted in MORNINGSIDE COLLEGE s buildings or residence hall with the exception of approved Service or Assistance Animals for individuals with disabilities. MORNINGSIDE COLLEGE is committed to providing reasonable accommodations to qualified students with disabilities. Students with disabilities who require the use of Service or Assistance Animals as a reasonable accommodation may be permitted to bring such animals on campus provided that they comply with MORNINGSIDE COLLEGE s policies regarding such animals. Students who seek to bring a Service or Assistance Animal must complete the Morningside College Service and Assistant Animal Application and submit it to the office of residence life PRIOR to bring the animal to campus The Office of Residence Life will work with Disability Services and other campus offices to determine whether to approve the student s request for a Service or Assistance Animal. In making this determination, the College will consider the needs of the student, as well as the impact of the animal on the campus community. Students seeking to have a Service or Assistance Animal in housing must submit a request for review each academic year. A request for a Service or Assistance Animal should be submitted along with the student s application for housing. The animal must not be in residence prior to approval by the College. The approval of a request is animal-specific and is not transferable to another animal. II. Definitions A. Service Animal A "Service Animal" is any dog that has been individually trained to do work or perform tasks for the benefit of an individual with a disability. Other animals, whether wild or domestic, trained or untrained, do not qualify as Service Animals. Examples of work or tasks provided by a Service Animal include, but are not limited to, guiding a person with impaired vision, alerting a person with a hearing impairment, pulling a wheelchair, and alerting and protecting a person who is having a seizure. Service Animals are working animals, not pets. The work or task a Service Animal has been trained to provide must be directly related to the functional limitations of the person s disability. Animals whose sole function is to provide comfort or emotional support do not qualify as Service Animals. B. Assistance Animal Assistance Animals (sometimes referred to as emotional support animals, social or therapy animals, companion animals, and/or comfort animals ) are animals that perform tasks and/or provide service, assistance, or emotional support which alleviates one or more identified symptoms or effects of an individual s disability. Assistance Animals do not assist with daily living tasks and are not required to have received special training. They must provide relief for an identified emotional or psychiatric disability. Assistance Animals stay only in residence; they do not accompany an individual with a disability at all times (i.e., Assistance Animals do not attend class, enter the library or visit other residence halls or dining halls). C. Pet A Pet is an animal kept for ordinary use and companionship. A pet is not considered a Service or an Assistance Animal. Pets are not covered by this policy. Individuals are not permitted to keep or bring pets, other than fish in a 10-gallon tank, into MORNINGSIDE COLLEGE housing. D. Individual with a Disability An Individual with a Disability is a person who (1) has a physical or mental impairment that limits one or more of a person s major life activities or (2) has a record of having, or being perceived as having, a physical or mental impairment. E. Approved Animal Service & Assistance Animal Packet Page 2 of 13

3 An Approved Animal is a Service Animal or an Assistance Animal that has been permitted in MORNINGSIDE COLLEGE housing as a reasonable accommodation under this policy. F. Owner The Owner is the student who has requested the accommodation and has received approval to bring the Approved Animal on campus. III. Definitions A. Service Animals A resident student seeking to keep a Service Animal in housing must make a formal request to the Office of Residence Life. Students seeking permission to keep a Service Animal in COLLEGE housing must submit the Service and Assistance Animal Registration Form so that the student can be assigned to the most appropriate housing location with their Service Animal, considering the student s needs and preferences. Students do not need to submit a Housing Accommodations Request Form unless they are requesting additional housing accommodations from the College. Requests should be submitted when the student applies for housing or as soon as possible before the semester the animal is requested and by the deadlines specified by MORNINGSIDE COLLEGE. Requests submitted after the deadline or after the student is already placed in housing may take 30 days or more; accordingly, students should submit their requests at least 30 days prior to the date the student would like to bring the animal to housing. When the need for a Service Animal is not readily apparent, MORNINGSIDE COLLEGE may request additional documentation in support of the request for the purpose of determining whether an animal qualifies as a Service Animal, namely: (1) that the Service Animal is required due to the functional limitations of the requesting individual s disability; and (2) what work or tasks the Service Animal has been trained to perform for the benefit of the owner. Any necessary documentation must be dated within the last 12 months. If the request for a Service Animal is approved, the requesting student will be asked to acknowledge, in writing, receipt of, and their agreement to comply with, this policy. If the request for a Service Animal is approved, Residence Life staff will make a reasonable effort to notify the other residents that a Service Animal will be in the living area. This notice will be limited to information about the animal s presence; there will be no disclosure of the student s disability. Other resident students with medical conditions who are affected by animals (e.g., severe allergies, respiratory diseases), are asked to contact the Office of Residence Life if they have a health or safety related concern about exposure to a Service Animal. Such affected students may be eligible for a disability accommodation when living in proximity to a Service Animal. Residence Life staff will collaborate as necessary to resolve conflicts related to a Service Animal. Staff members will consider the needs and/or accommodations of all resident students involved. Residence Life may relocate the Owner and Approved Animal if necessary to accommodate other students with medical condition(s) who are affected by animals or in other circumstances as deemed appropriate in the sole discretion of MORNINGSIDE COLLEGE. Service Animals may travel freely with their Owner throughout MORNINGSIDE COLLEGE housing and other areas of MORNINGSIDE COLLEGE unless animals are prohibited due to health and safety restrictions. A Service Animal shall have a harness, leash, or other tether, unless either the handler is unable because of a disability to use a harness, leash, or other tether, or the use of a harness, leash, or other tether would interfere with the Service Animal s safe, effective performance of work or tasks, in which case the Service Animal must be otherwise under the handler s control (e.g., voice control, signals, or other effective means). Service & Assistance Animal Packet Page 3 of 13

4 B. Assistance Animals (including Emotional Support Animal) A resident student seeking to keep an Assistance Animal (includes Emotional Support Animal or ESA) in housing must make a formal request to the Office of Residence Life. Requests should be submitted when the student applies for housing or as soon as possible before the semester the animal is requested and by the deadlines specified by MORNINGSIDE COLLEGE. Requests submitted after the deadline or after the student is already placed in housing may take 30 days or more; accordingly, students should submit their requests at least 30 days prior to the date the student would like to bring the animal to housing. When the need for an Assistance Animal is not readily apparent, MORNINGSIDE COLLEGE may request additional official written documentation from a physician, psychiatrist, or other mental health professional, including (1) verification of the student s disability, (2) a statement on how the animal serves as an accommodation for the documented disability, and (3) a statement on how the need for the Assistance Animal relates to the ability of the student to use and gain benefit from MORNINGSIDE COLLEGE housing. Any necessary documentation must be dated within the last 12 months. If the request for an Assistance Animal is approved, the requesting student will be asked to acknowledge, in writing, receipt of, and their agreement to comply with, this policy. If the request for an Assistance Animal is approved, Residence Life staff will make a reasonable effort to notify the other residents that an Assistance Animal will be in the living area. This notice will be limited to information about the animal s presence; there will be no disclosure of the student s disability. Other resident students with medical condition(s) who are affected by animals (e.g., severe allergies, respiratory diseases) are asked to contact the Office of Residence Life if they have a health or safety related concern about exposure to an Assistance Animal. Such affected students may be eligible for a disability accommodation when living in proximity to an Assistance Animal. Residence Life staff will collaborate, as necessary, to resolve conflicts related to an Assistance Animal. Staff members will consider the needs and/or accommodations of all resident students involved. Residence Life may relocate the Owner and Approved Animal if necessary to accommodate other students with medical condition(s) who are affected by animals or in other circumstances as deemed appropriate in the sole discretion of MORNINGSIDE COLLEGE. Assistance Animals must be contained within the privately assigned residential area (room, suite, apartment) at all times, except as otherwise expressly provided. When transported outside the private residential area, assistance animals must be in an animal carrier or controlled by leash or harness. IV. Responsibilities of the Owner of Service or Assistance Animal A. The Owner is responsible for assuring that the Approved Animal does not unduly interfere with the routine activities of the residence or cause difficulties for students who reside there. In addition, the Approved Animal must not pose a threat to the health, safety, or property of anyone in the MORNINGSIDE COLLEGE community. If MORNINGSIDE COLLEGE determines that the Approved Animal threatens the health, safety, or property of anyone in the MORNINGSIDE COLLEGE community, or that the Approved Animal is adversely affecting MORNINGSIDE COLLEGE s programs and activities, MORNINGSIDE COLLEGE will take appropriate measures, up to and including a determination that the Approved Animal may no longer be permitted on campus. B. The Owner must always be in control of the animal. The care and supervision of the Approved Animal is solely the responsibility of the Owner. The Owner is responsible for ensuring the safety of the Approved Animal and the MORNINGSIDE COLLEGE community. The Owner must not have any past or current student conduct issues that may impact the Owner s ability to care for and effectively control an animal. If MORNINGSIDE COLLEGE determines that such conduct issues are negatively impacting the safety of the Approved Animal or the MORNINGSIDE COLLEGE community, MORNINGSIDE COLLEGE will take appropriate measures, up to and including a determination that the Approved Animal may no longer be permitted on campus. C. The Owner is financially responsible for the actions of the Approved Animal, including bodily injury or property damage. The Owner s responsibility covers but is not limited to replacement of furniture, carpet, windows, wall coverings, and the like. The Owner is expected to cover these costs at the time of repair. Service & Assistance Animal Packet Page 4 of 13

5 D. The Owner is responsible for any expenses incurred for cleaning above and beyond a standard cleaning or for repairs to MORNINGSIDE COLLEGE premises that are assessed after the student and animal vacate the residence. The MORNINGSIDE COLLEGE shall have the right to bill the Owner s account for unmet obligations. E. The Owner is responsible for ensuring the cleanup of the Approved Animal's waste and, when appropriate, must toilet the Approved Animal in areas designated by the MORNINGSIDE COLLEGE consistent with the reasonable capacity of the Owner. Indoor animal waste, such as cat litter, must be placed in a sturdy plastic bag and securely tied up before being disposed of in outside trash dumpsters. Litter boxes should be placed on mats so that waste is not tracked onto carpeted surfaces. F. The Owner is financially responsible for any expense of pest treatment that is beyond routine pest control. The Owner s residence may be inspected for pests as needed and the Residence Life staff will schedule any such inspection. If pests are detected upon inspection, the residence or residence hall will be treated using MORNINGSIDE COLLEGEapproved pest control methods and the Owner is expected to cover these costs at the time they are incurred. G. The Owner understands that MORNINGSIDE COLLEGE may use pesticides, pest-control devices, de-icing materials, cleaning supplies and other materials for the maintenance and operation of housing and the Owner acknowledges and agrees that MORNINGSIDE COLLEGE is not responsible for any harm to Approved Animals caused by such materials. H. The Owner is responsible for the overall health and well-being of the Approved Animal. This includes but is not limited to: 1. Vaccinations: In accordance with local ordinances and regulations, the Approved Animal must be immunized against diseases common to that type of animal. Dogs must have current vaccination against rabies and wear a rabies vaccination tag. Cats should have the normal shots required for a healthy animal. Local licensing requirements must be followed. 2. Approved Animals to be housed in MORNINGSIDE COLLEGE housing must have an annual clean bill of health from a licensed veterinarian. Documentation can be a vaccination certificate for the animal or a veterinarian's statement regarding the Approved Animal's health. MORNINGSIDE COLLEGE has authority to direct that the Approved Animal receive timely veterinary attention (e.g., if fleas, ticks, or other pests are detected through inspection (as per Section IV. F. above), and to require documentation demonstrating the Approved Animal has been treated. 3. MORNINGSIDE COLLEGE reserves the right to request documentation showing that the Approved Animal has been licensed pursuant to Iowa. I. Approved Animals must be taken with the student if they leave campus for a prolonged period of time. Approved Animals may not be left overnight in MORNINGSIDE COLLEGE housing to be cared for by another student. J. The Owner must notify the Office of Residence Life in writing if the Approved Animal is no longer needed or is no longer in residence. K. The Owner agrees to continue to abide by all other residential policies. A reasonable accommodation which may constitute an exception to a policy that otherwise would prohibit having an animal does not constitute an exception to any other policy. L. In the event of an emergency, college officials and emergency responders will prioritize the safety and wellbeing of students, faculty, staff, and guests to campus. Officials and responders are not responsible for removing animals during an emergency, and may not be held responsible for the care, damage to, or loss of the animal. Service & Assistance Animal Packet Page 5 of 13

6 M. The Owner shall indemnify and hold harmless MORNINGSIDE COLLEGE from all expenses, injuries, or claims arising out of the Owner s control and/or use of the Approved Animal. V. Notice and Education to MORNINGSIDE COLLEGE Community Where appropriate, in the sole discretion of MORNINGSIDE COLLEGE, Disability Services, Residence Life, staff may provide notice of or offer targeted training to members of the MORNINGSIDE COLLEGE community most likely to come in contact with a Service or Assistance Animal. VI. Housing Assignments for Students with Approved Animals and Community Considerations A. Students with medical condition(s) that are affected by animals (e.g., respiratory diseases, asthma, severe allergies) must contact Disability Services if they have a health or safety related concern about exposure to an Approved Animal. The College is prepared to reasonably accommodate individuals with such medical conditions should they require accommodation when living in proximity to Service Animals or Assistance Animals. B. Housing personnel will make a reasonable effort to notify tenants in College housing where the Approved Animal will be located. C. Disability Services and Residence Life Staff will work to resolve any conflict as a result of the presence of an Approved Animal in a timely manner. Staff members will consider the conflicting needs and/or accommodations of all persons involved. D. All roommates of the Owner must sign the agree in writing to allow the Approved Animal to be in College housing with them. The roommates must communicate this written consent to the appropriate Housing office. In the event that one or more roommates or suitemates do not agree, either the Owner and Approved Animal or the nonapproving roommates or suitemates, as determined by the appropriate Housing office, may be moved to a different location. Where the Owner s roommate or suitemate already has a previously Approved Animal living in the room or suite, the College reserves the right to deny the application of the Owner to have an Approved Animal or to move the Owner to a different location, if one is available. The College will consider each instance where multiple Approved Animals may be present in a room or suite on a case-by-case basis, accounting for both the needs of the students involved, and the health and safety of the Approved Animals. The College is not required to re-assign an Owner to a single-occupancy unit because the Owner is approved for an animal. VII. Exceptions and Exclusions/Removal of Animals A. The College may impose some restrictions on, and may even exclude or ban, an Approved Animal in certain instances. Restrictions or exclusions will be considered on a case-by-case basis. Access to College property may be restricted or revoked under the circumstances outlined below. The College may contact Animal Control or another animal welfare agency to remove the Approved Animal. The College reserves the right to remove or exclude an Approved Animal from campus if: 1. Direct threat to health and safety: The Approved Animal poses a direct threat to the health and safety of others, or if the threat to the safety of others cannot be reduced or eliminated by reasonable modifications. An example of this would be an Approved Animal that exhibits aggressive behaviors or has injured a person or another animal. In considering whether an Approved Animal poses a direct threat to the health or safety of others, an individualized assessment based on reasonable judgment, current medical knowledge, or the best available objective evidence will be conducted to determine 1) the nature, duration, and severity of the risk; 2) the probability that the potential injury will actually occur; and 3) whether reasonable modifications of policies, practices, or procedures will mitigate the risk. Service & Assistance Animal Packet Page 6 of 13

7 2. Owner does not maintain control of animal: In the event that the Approved Animal creates an unmanageable disturbance or interference with the College community, the animal may be removed. An Owner may be directed to remove an animal that is out of control if the Owner does not take effective action to gain and maintain control. Owners are expected to maintain control of the Approved Animal at all times. The Owner may be prohibited from bringing the Approved Animal into any College facility until the Owner can demonstrate that s/he has taken significant steps to control the Approved Animal s behavior. An example of this may be an Assistance Animal that repeatedly gets out of student s housing or a Service Animal being let loose in the library, even if it does not physically injure a person or another animal. 3. Fundamental Alteration/Undue Burden: If the Approved Animal s presence results in a fundamental alteration of the College s program or an undue burden to the College, the Approved Animal may be removed. a) Students may be denied the accommodation of an Approved Animal in an academic setting if the animal s presence fundamentally alters the nature of the educational program. An example of this may be a lab course that requires a sterile working environment and the Approved Animal s presence would compromise the sanitation/operational standards for the lab. Another example may be a lab course involving the use of lab animals and the Approved Animal s presence will be disruptive to the lab animals. Note: Assistance Animals are not permitted to accompany students on campus aside from housing. b) Additionally, if the Approved Animal or its presence creates an unmanageable disturbance or interference with the College community, this may be considered an undue burden for the College. 4. Improper/Inadequate Care of Animal: Owners must ensure that Approved Animals are properly housebroken and/or trained. They must also ensure that the Approved Animal and its environment are maintained in a healthy, clean manner. The Approved Animal may be removed if it: o Is not certified by a licensed veterinarian as being in good health. o Is not current with required vaccinations under local and state regulations. a) Exhibits signs of abuse or neglect. b) Note: the College may report the animal abuse or neglect to the appropriate authorities, in addition to taking appropriate College disciplinary action. c) Is not housebroken. 5. The Owner does not comply with Owner s Responsibilities in College Housing (refer to Section IV of this document) 6. Damage and/or Harm Caused by Approved Animal a) The Owner is solely responsible for any harm to persons or property damage caused by the Approved Animal. b) The College and College officials may take any and all reasonable and necessary actions to report or disclose damage and/or harm caused by an Approved Animal to the appropriate College office or government agency. c) The Owner is solely responsible for any injuries or damage to College or other personal property caused by their Approved Animal. Service & Assistance Animal Packet Page 7 of 13

8 By my signature below, I verify that I have read, understand and will abide by Morningside College s Service and Assistance Animal Guidelines and Procedures and agree to provide the additional information required to complete my request for a reasonable accommodation under the College s Service and Assistance Animal Guidelines and Procedures. Final decisions will be delivered via from the Office of Residence Life or Office of Disability Services. Student Name (print): Morningside Student ID #: Student Signature: Date: Service & Assistance Animal Packet Page 8 of 13

9 RESIDENCE HALL SERVICE AND ASSISTANCE ANIMAL REGISTRATION FORM Students planning to bring A Service or Assistance Animal to reside in College housing are required to follow the procedures outlined in Service and Assistance Animal Guidelines and Procedures. Deadlines: Students must submit the Service and Assistance Animal Request Form and disability documentation in accordance with the housing accommodation deadlines outlined below: Deadline for FALL Semester Deadline for SPRING Semester May & Summer Session Returning students March 1 st November 15 th 30 days prior to move in New students (First-year & transfer) May 1 st December 15 th 30 days prior to move in Timeline for Decision on Accommodation Requests Completed By Deadline Fall Semester Spring Semester May & Summer Session Returning students New students (First-year & transfer) 15 days after completed request (March 15 th ) 30 days after request (June 1 st ) 30 days after completed request (December 15 th ) 30 days after completed request (December 15 th ) 15 days after completed request (May 15 th ) 15 days after completed request (May 15 th ) Late Accommodation requests will be processed as received. Please allow 30 days for processing. Owner s Name: Student ID #: Owner s Phone: Section A pertains to Service Animals. Section B pertains to Assistance Animals (Emotional Support Animals). Section C pertains to both Service and Assistance Animals (Emotional Support Animals). A. Service Animals Only: The Americans with Disabilities Act defines services animals as a dog that is individually trained to do work or perform tasks for a person with a disability. 1. My Service Animal is a dog: YES NO (contact the Office of Residence Life) 2. My Service Animal is required because of my disability: YES NO 3. List tasks/work your Service Animal is trained to perform: a. Task b. Task 4. Complete Section C Service & Assistance Animal Packet Page 9 of 13

10 B. Assistance Animal (Emotional Support Animals) Only: An assistance animal (emotional support animal) is not a pet. It is an animal that works, provides assistance, or performs tasks for the benefit of a person with a disability, or provides emotional support that alleviates one or more identified symptoms or effects of a person's disability. 1. My animal is an Assistance Animal or Emotional Support Animal: YES NO 2. Submit a completed Accommodation Verification Form for Assistance (Emotional Support) Animals in Housing. 3. Indicate the symptoms of your disability, the assistance that your animal provides to mitigate those symptoms and why the animal is necessary for you to use and enjoy your residence: C. Both Service and Assistance Animals: 1. Date you wish to bring your Service or Assistance Animal to campus: 2. Do you already live in Morningside College Housing? YES NO a. If yes, please provide location/address: b. If no, please indicate your move-in date: 3. Do you currently live with roommates on campus? YES NO a. Roommates will be notified or Morningside College s policy regarding service and assistance animals. 4. Type of Animal: Dog Cat Other: 5. Do you already own the animal? a. YES (if yes, complete 6-11) b. NO (if no, indicate date when you will obtain animal: ) i. You will need to complete 6-11 once the animal is obtained. 6. Physical Description of Animal (breed, weight, coat color, pattern, other identifying features): 7. Name of Animal: 8. Animal Emergency Contact Information In the event you are unable to care for your animal who should we contact? a. Name: Phone: b. Address (street, city, state): 9. Attach a photo of the animal. 10. Submit animal health records, including verification that the animal has all veterinary-recommended vaccinations to maintain good health and prevent contagious disease, including current rabies vaccinations for dogs and cats. 11. If the animal is a dog or cat, you must license the animal with the City of Sioux City every year. For more information see Please provide confirmation that your animal has been licensed. Service & Assistance Animal Packet Page 10 of 13

11 SERVICE AND ASSISTANCE ANIMAL RESIDENCE HALL ROOMMATE AGREEMENT TO BE COMPLETED BY SERVICE OR ASSISTANCE ANIMAL OWNER Owner s Printed Name Owner s Signature Residence Hall Student ID# Date Room # TO BE COMPLETED BY SERVICE OR ASSISTANCE ANIMAL OWNER S ROOMMATE(S) With my signature below, I agree to share the common areas of my assigned residential space with the service or assistance animal that my roommate has been approved to have. I have received the Morningside College Residence Hall Service and Assistance Animal Policy and have an understanding of the expectations that must be upheld. Should I have any concerns regarding the care and control of the approved animal, I will discuss my concerns with the animal s owner, then with my Resident Assistant, or the Office of Residence Life, if the animal s owner and I cannot come to an agreement. Residents Printed Name Residents Signature Student ID# Date Residents Printed Name Residents Signature Student ID# Date Residents Printed Name Residents Signature Student ID# Date Service & Assistance Animal Packet Page 11 of 13

12 ACCOMMODATION VERIFICATION FORM FOR ASSISTANCE (EMOTIONAL SUPPORT) ANIMALS IN HOUSING TO BE COMPLETED BY THE STUDENT: Resident (Student) Name: Date of Birth: Morningside College Student ID#: Authorization to Receive Information I authorize the Morningside College Residence Life and Disability Services, to receive information from the professional who fills out this Housing Accommodation Request form, and for him/her to discuss my condition(s) with Residence Life and/or Disability Services, if necessary. Student Signature: Date: Morningside College provides reasonable accommodations to students with disabilities who have a verifiable need for the reasonable accommodation. A reasonable accommodation is an exception to the usual rules, policies, practices, or services that a resident with a disability may need to have an equal opportunity to use and enjoy on campus housing TO BE COMPLETED BY THE QUALIFIED IMPARTIAL PROFESSIONAL: Instructions for qualified impartial professional: The individual below has made a request for accommodations. Please review the statement below and provide the information requested. This form is to be completed by a qualified impartial professional (psychologist; neuropsychologist; psychiatrist; other relevantly trained medical doctors) with experience and expertise in the area for which accommodations are being requested, who is not a family member. About Morningside College Housing: The majority of Morningside College students live in a traditional style Residence Hall Community. The student shares a 2-person rooms (approx x 11 or 181 sq. ft.) with one other student. The students live on a floor with other students and share common restroom facilities. Students share lounge space, kitchen space, and other common areas in the building with their entire community, up to 380 other students. Assistance Animals must be contained within the privately assigned residential area (room, suite, apartment) at all times, except as otherwise expressly provided. When transported outside the private residential area, assistance animals must be in an animal carrier or controlled by leash or harness. Americans with Disabilities Act and Fair Housing Act: An individual with a disability is defined by the ADA as a person who has a physical or mental impairment that substantially limits one or more major life activities, a person who has a history or record of such an impairment, or a person who is perceived by others as having such an impairment. Under this definition, an impairment is a disability if it substantially limits the ability of the person to perform a major life activity as compared to the average person in the general population. The definition also takes into account any mitigating measures, such as medication or other treatment or therapies, the person is employing that may relieve the substantial limitations caused by the impairment. If the mitigating measure(s) eliminates the substantial limitation caused by their impairment, the person does not have a disability. 1. Does the resident have a disability under this definition? Yes No Service & Assistance Animal Packet Page 12 of 13

13 2. Please identify the resident s specific impairment(s) describe how each impairment or symptom substantially limits his/her ability to perform a major life activity (i.e. walking, breathing, sleeping, seeing, hearing, learning, socializing) as compared to most people in the general population. 3. Is the accommodation animal an integral component of a treatment plan prescribed by a medical professional for the condition in question? What are the consequences to the student if the accommodation is not approved? 4. Please explain how the accommodation animal is necessary for the resident to use and enjoy College housing and maximize the potential of their educational experience as compared to a person without a disability. How will the assistance animal offset the symptoms of the disability? 5. Please identify any other accommodation that may be equally effective in allowing the resident to use and enjoy Morningside College Housing. 6. Expected duration of the disability/condition. (Permanent, temporary, stable, progressive, other) Signature of Qualified Professional: Date: Name of Qualified Professional (print): Position Qualified Professional: License No. State: Phone: Name of Institution/Agency/Place of Employment: Address - Street: City: State: Zip: Fax Number: Address: Please return this signed document to: Morningside College Residence Life, 1501 Morningside Ave, Sioux City, IA Phone: Fax: housing@morningside.edu Service & Assistance Animal Packet Page 13 of 13