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Online Student Application

Two easy steps to register
Please answer the following questions to the best of your ability. By filling this out, you are agreeing that you are the student. If you have any questions, please call or email DSS at 205-934-4205 or

Please use your UAB email and login information to complete the application.
Personal Information
  1. Note: Select when you would like to start your services.
  2. Note: Select when you plan to graduate.
  3. Hint: Enter 9 alpha numeric characters.
  4. Hint: Enter date in the following format Month/Day/Year (i.e. 12/31/2010).
Contact Information
  1. Hint: Enter 10-digit number only (i.e. enter 9998888888 for 999 888 8888).
  2. Hint: Enter 10-digit number only (i.e. enter 9998888888 for 999 888 8888).
Additional Information
  1. How will you be taking courses?*
  2. How did you hear about DSS?*
  3. Please indicate the type and nature of disability you experience
  4. Functional Limitations: Please check any of the major life activities listed below that you believe are affected as a result of your diagnosed disability.
  5. Have you used accommodations in the past?*
  6. Are you requesting accommodations for taking tests/exams?*
  7. Are you requesting assistance with notetaking?*
  8. Are you requesting assistive technology? (DSS can evaluate what technology will best serve the student and their individual need).*
  9. Does your disability potentially impact your on-campus housing? (Note: You are responsible for submitting a housing application and indicating you would like to request accommodations)*
  10. Are you requesting access to paratransit services? (If you are needing immediate paratransit access it is your responsibility to contact DSS directly by phone, 934-4205, or emailing*
  11. If you have additional comments or concerns not addressed in this application, please let us know in the space below.*
  12. If you need accommodations for the information session or intake appointment, please let us know.*
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