Intake Form

First Name (preferred) *

Last Name *

Legal Name (if different from preferred)

Student ID#

Pronouns (optional)

he/him/his

she/her/hers

they/them/their

Student Email Address *

Phone Number

Major

When will you first need academic/classroom accommodations? (optional)

Summer 2025

Fall 2025

Spring 2026

If you have ever had academic/classroom accommodations at a previous school, what types of accommodations did you use?

Upload Documentation

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256 MB limit.
Allowed types: gif, jpg, jpeg, png, tif, txt, rtf, html, pdf, doc, docx, ppt, pptx, xls, xlsx, xml.

I understand that submitting this form and documentation does not complete the accommodation process. I still need to complete an intake appointment with my assigned coordinator, then request accommodations in my courses. *

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