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DRC Student Registration Form
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DRC Student Registration Form
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Student Information
Please enter your information
First Name
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:
Last Name
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Middle Name
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Student ID
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Email
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Please use your university issued email address
Student Phone Number
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Are you a Health Science Student?
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:
AHS, CON, COM, DENT, JACSW, PHARM, SPH
Are you a Health Science Student?
Yes
Are you a Health Science Student?
no
Specific Accommodation Information
My diagnosed disability(ies) best fall into the following category(ies)
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[Select]
[Select]
clear
How does your disability affect you academically?
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How does your disability affect student life in general, like housing and transportation?
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What, if any, accommodations have you received in the past?
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What additional information would you like DRC to know about your request?
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What accommodations are you requesting
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Upload supporting document(s)
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Next Step: Schedule an Intake Appointment
Please contact the Disability Resource Center at 312-413-2183 to schedule an Intake Appointment with a Disability Specialist.
ASD Related / Developmental
Attention Deficit/Hyperactivity
Blind / Low Vision
Chronic Health
Cognitive
Communication
Deaf / Hard of Hearing
Learning
Mobility
Psychological
Temporary (Injury)
Temporary (Pregnancy)
ASD Related / Developmental
Attention Deficit/Hyperactivity
Blind / Low Vision
Chronic Health
Cognitive
Communication
Deaf / Hard of Hearing
Learning
Mobility
Psychological
Temporary (Injury)
Temporary (Pregnancy)