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Online Disability Self-Disclosure

We're glad you decided to connect with us!

You can use this form to self-identify as a student with a disability, or to connect with our office to learn more about how we can support you. Determination of any accommodations or services is done through an interactive process with you.

If you are seeking accommodations or services, or want to explore if you have a disability:

Step 1: Complete this Disability Self-Disclosure Form. You can do this even if you are not sure about your disability or if you have questions.

Step 2: You can submit any supporting documentation you have when you complete this form, or can send it to us later.

Step 3: We will review the information you submitted and follow up with you regarding the next steps.

Information provided is kept confidential.

Questions? Contact us or learn more on our website.
Personal Information
  1. Note: Select when you would like to start your services.
  2. Note: Select when you plan to graduate.
  3. Hint: Enter your 7 digit Cornell ID Number
Contact Information
  1. Hint: Enter 10-digit number only.
  2. Hint: Enter 10-digit number only.
Questions
  1. What is your status at Cornell? *
  2. What is your college or school at Cornell? *
  3. What is your degree program? *
  4. Which campus are you on? *
  5. Into which of the following categories does your disability (or disabilities) fall? You may select more than one:
  6. Are you requesting disability services? Please select one of the following: *
  7. Does your disability affect you in an academic setting? If so, please explain. *
  8. List the accommodations you are requesting in an academic setting (e.g., test-taking accommodations, books in alternative format). *
  9. Have you requested on campus housing? If so, please specify building and room number: *
  10. Does your condition affect you in a residential setting (e.g., residence halls, dining halls)? If so, please explain *
  11. List the disability-related accommodations you are requesting in a university-owned residential setting (e.g., strobe alarms, wheelchair-accessible housing), if applicable. *
  12. Does your condition affect your transportation needs (e.g., bus pass, accessible parking, paratransit service)? If so, please explain *
  13. Describe auxiliary aids, assistive technology, and/or services that you anticipate using while attending Cornell (e.g., service dog, personal assistant, FM system, wheelchair). *
  14. List the secondary school(s) you attended and any disability accommodations and/or services you used in high school. *
  15. List any colleges attended and disability accommodations and/or services used there. *
  16. List any national standardized exams (e.g., SAT, ACT, GRE, LSAT, GMAT) you have taken and any accommodations used for each. *
  17. Review SDS documentation guidelines at sds.cornell.edu to know what documentation or information is helpful to submit. If you have copies of IEP/504 plans and/or accommodation letters from national standardized exams, those are generally helpful to submit as well. (Online submission using this site is a secure method of submitting documentation.) Please note that files must be 5MB or less in size. *
  18. I authorize SDS to discuss my documentation with the clinician who authored the documentation, or a similarly-qualified Cornell clinical staff person or consultant, if additional information or clarification is required. *
  19. By submitting this form, I certify that the information provided on this form is accurate. I understand that to be eligible for access accommodations at Cornell University I must (1) submit this completed form, (2) participate in an initial individual assessment with a Student Disability Services staff person, and (3) submit supporting documentation (if requested). *
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