Accommodation Request

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Student Information

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Preferred Pronouns

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Do not put an 'E' in your ID number.

Student-Identified Campus:Required
Student StatusRequired







Specific Accommodation Information

My diagnosed disability falls into the following categoryRequired
DurationRequired


Do you have another condition to report?Required
Please describe accommodations you have had in the past, or areas in which you currently need assistance.
Upload Documents

Students who are seeking accommodation support services from the Disability Services Office are required to produce documentation that verifies the eligibility of the student under the Americans With Disabilities Act (ADA) and Section 504 of the Rehabilitation Act of 1973. Documentation serves as a foundation that legitimizes the student’s request for accommodations that are appropriate and reasonable. The documentation presented must describe the nature of the disability and its impact on learning.

To learn more about documentation, please follow this link.

Disclosure InformationRequired

This information is to be utilized by Dallas College to assist in my educational program. I authorize Accessibility Services to release information to campus personnel (instructors, success coaches, case managers, interpreters, etc.) from my record, which may or may not include information about my disability, for purposes of preparing/ providing services, I might need.

Consent for Release of Information
In addition to campus personnel, I authorize release of the above information to the individuals specified below if applicable.

• Texas Workforce Commission-Vocational Rehabilitation Services Representative
• I am a student with IDD and/or ASD, and I give my permission for Dallas College Disability Support Services personnel to release my disability diagnosis to the Texas Higher Education Coordinating Board. I understand that this information will only be used to determine the number of students with IDD and/or ASD attending college in the state of Texas, and ultimately, to create new educational programming to assist students.
• I am a Dual Credit student

Renew Accommodations InformationRequired
I understand accommodations do not automatically renew from semester to semester, and I must contact Accessibility Services at the beginning of every semester to receive my accommodations.
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