Forms and Documents
Applying for Services
Students interested in receiving reasonable accommodations will need to submit an Application for Support Services and documentation of their disability. Students can provide DSS with documentation of their disability that is currently in their possession, or they can have a treatment provider fill out the Verification of Disability Form. If a student has prior documentation from another university a recent copy can be used in lieu of a Verification of Disability Form. Please be advised that most IEPs and 504 Plans do not include actual disability documentation. It is also best to contact the last school attended and request a copy of the actual disability documentation on file rather than just providing a copy of what was authorized for accommodations. Students over the age of 18 must complete a Permission to Release form to transfer certain rights to their parent(s)/guardian(s). All forms are available below for download. Any student who is experiencing pregnancy related complications are encouraged to consult with Disability Support Services to determine what academic adjustments they might be eligible to receive. In addition, pregnant students are strongly encouraged to contact the DHR/Title IX Office to see what support can be provided by that respective program.
- Application For Support Services
- Verification of Disability Form
- Permission to Release Information on File in Disability Support Services
Special Note: DSS will only keep students’ records for 7 years after the date they were last enrolled in a course. Please be advised all DSS students’ records that are 7 years old (or older) will be both shredded and electronically deleted. All students are strongly encouraged to keep a copy of their own records for future use.
Course Materials in Alternative Formats (E-Text)
Students with documented print impairments, or are otherwise in need of this service, must work closely with their DSS Counselor and should complete the following forms each semester in which course materials in alternate formats are required.
Once verified with DSS please fill out the following forms to request your alternative format(s).
- Alternative Format Request and Copyright Agreement Form
- Classroom Materials in Alternative Format Policy
Request for Waiver of Parking Fee
Students with disabilities who possess a distinguishing license plate or placard issued by the State of California's Department of Motor Vehicles or by the appropriate authority of another state, and who have demonstrated financial need for parking fee financial assistance as determined by the campus president according to the need analysis procedure for campus based financial aid may be eligible for a parking fee waiver. The completed form and "Shopping Sheet" will need to be submitted to Parking and Commuter Services.
Special Accommodations for On-Campus Housing
Students interested in receiving special accommodations in order to take part in on campus housing will need to submit documentation that clearly supports their requested accommodation. In addition, utilizing the interactive process, students will need to meet with a DSS Counselor to talk about their requested housing accommodation and review their supporting disability documentation. Students should complete Section 1 of the Housing: Special Accommodation Request Form and then schedule an appointment to meet with a DSS Counselor. Please do not assume that you will automatically be considered for housing accommodations without having first made the request and consulting with a DSS Counselor. In addition, you must submit a housing application and notify Campus Housing of your need for special accommodations as well. Failure to submit your housing application in timely manner may likely impact our ability to meet your housing needs.
Emotional Support Animals
Students who have a disability related need for an Emotional Support Animal to reside with them within on campus housing will need to complete the forms provided below.
Form Submission Options
All forms can be returned to the DSS Office located in Administrative Building 4200. In addition, completed forms can be emailed to email@example.com, faxed to (760) 750-3445 or mailed directly to us.
The forms provided in this section of our homepage are not exhaustive. If you are interested in learning more about DSS, or in accessing additional forms, then please call us at (760) 750-4905 or email us at: firstname.lastname@example.org.