UC Blue Ash Online Application for Accessibility Services

Student's Full Name:

First NameLast Name

UC Student Username:

bearcabac

UC Email:

Only UC email accounts can be used by Accessibility Resources to communicate with UC students.

Student ID (M-Number)

M########. Can also be found on your student ID.

Phone Number:

Area CodePhone Number

Date of Birth:

MonthDayYear

Home College: Select the College of your primary major

Intended Major:

Current student status:

Other

What semester are you requesting academic accommodations start in? (If you're an incoming Freshman starting in Fall 2020, please select Fall 2020)

Other

Are you a Distance Learner? (Example: All of your courses are online)

Are you seeking permanent or temporary accommodations? (Temporary accommodations would be for injuries, surgeries, temporary conditions etc.)

For what disability are you seeking accommodations?

How does your disability impact you in the academic setting?

Examples: test-taking, class attendance, taking notes, understanding materials, speaking, comprehension, etc.

During your intake interview, will you require any accommodations? Please list any accommodations you would like to request.

List and describe (if applicable) any other areas of University Life that might be impacted by the disability (housing, transportation, building accessibility, parking, etc.)

Are you transferring from a University of Cincinnati branch campus?

If yes, did you receive accommodations at that campus?

Did you receive special education services or accommodations in K-12 or at another post-secondary education institution? If so, check all that apply:

If deemed eligible for services, what accommodation(s) are you requesting from Accessibility Resources?

Are you working with any external support networks or organizations? (Example: Vocational Rehabilitation Services, Veterans Services, etc.). If so, what services or assistance are they providing?

Have you been prescribed medication applicable to your disability? If yes, how does the medication impact your daily function and /or academic work?

What areas do you excel at and enjoy (academic, social, other) at the University of Cincinnati? Please explain.

What areas are more challenging for you (academic, social, other)? Please explain.

Please share any additional information you would like to provide.

Medical Professional Disability Verification Form or Supporting Disability Documentation

Browse Files

Please upload your Medical Professional Disability Verfication form or documentation supporting your request for accommodation that meets Accessibility Resource's documentation guidelines. Note: JPEG, PNG, or other image files containing photographs of documentation will not be accepted and may delay review of your documentation. Please provide scanned PDF or digital documents.

Additional Documents:

Browse Files

Upload any additional documentation, assessments, etc. in support of your request for academic accommodations.