Center for Access and Accommodations Intake Form

* indicates a required field

Center for Access and Accommodations Intake Process

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.