Accessibility Resources-Online Application for Services

Student's Full Name:

Have you used other names that might be on your submitted medical documentation?

M#:

UC Email:

Only UC email accounts can be used by Accessibility Resources to communicate with UC students.

Phone number:

Pronouns

Providing pronouns is optional

Group Selection Have you registered for accommodations at different UC campus?

Yes, at UC Blue Ash

Yes, at UC Clermont

Yes, at UC Clifton (Uptown)

Home College: Select the College of your primary major

Intended Major:

What semester are you requesting academic accommodations start in? Students beginning Fall 2022 should NOT complete this application until May 30th or later. Fall 2022 will become an option starting Monday, May 30th.

Summer 2022

Other...

Is this request due to an injury or illness that is temporary? (i.e., surgery, accident) If so, please explain

Thinking about your disability and your experience with learning and engaging in the classroom, what are the main concerns you would like Accessibility Resources to assist you with?

If you have received accommodations or special education services in the past, which were the most helpful for you?

Are there any other areas of university life that might be impacted by the disability (housing, transportation, building accessibility, parking, etc.)

Type Selection What is your preferred method for conducting your registration meeting?

In person

Video Conference (Teams, Zoom, WebEx, etc.)

Phone

Other

During your registration meeting will you require any accommodations? Please list any accommodations you would like to request?

Please share any additional information you would like to provide.

Group Selection Are you providing documentation with your application?

Yes

Other...

Medical Professional Disability Verification Form or Supporting Disability Documentation

Upload your Medical Professional Disability Verification form or documentation supporting your request for accommodation. Documentation is not required to register for services, however, if it is available, it can be a useful tool and help to ensure that the full consideration of the impact of your disability on the academic environment is considered.

Additional Documents: Upload any additional documentation, assessments, etc. in support of your request for academic accommodations

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