Center for Access and Accommodations Intake Form

* indicates a required field

Center for Access and Accommodations Intake Process

Please make sure you are checking your dupage.edu email address for follow up from our office. 

Please use your College issued email address
Are you a College of DuPage employee?Required

 

1. An incoming student needing accommodations, but I have NOT yet registered for classes

2. An incoming student needing accommodations, and I HAVE registered for classes

3. A returning student needing accommodations for the first time at COD

4. A current student exploring the Medical Appeals Process

5. A current student with a TEMPORARY medical issue or illness (examples- broken leg, COVID, The Flu)

6. A student taking classes through the Continuing Education Youth, High School, Dual Credit, or Dual Enrollment program and I need accommodations

7. Already registered with Access and Accommodations, but I have an additional accommodation request

Upload supporting document(s) (Letter from Healthcare Provider, IEP/504, disability testing, COVID positive results, etc)Required

By submitting this request, I give consent to the College of DuPage Center for Access and Accommodations to receive and confidentially store all information and documentation I have chosen to provide. I understand that the Center for Access and Accommodations may verify to other areas of the college that I am eligible for accommodations, however it is my responsibility to inform my instructors and other relevant individuals or departments of my approved accommodations. I am also responsible for informing the Center for Access and Accommodations of any changes to my needs or of any assistance I need coordinating my accommodations. I understand that my disability related needs must be clearly communicated to all relevant parties in a timely manner, and that accommodations are not retroactive. I, the student requesting accommodations, declare the truthfulness of the information provided on this form and the attached documentation.