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University of Georgia Disability Resource Center Request for Services Form

The office of the Disability Resource Center (DRC) is committed to providing equal access for students with disabilities at UGA. If you require accommodations at UGA, this form will provide you with the opportunity to request these accommodations from our office.

In order to receive accommodations, please complete the following steps:

1) Submit the Request for Services form below

2) Submit current disability documentation that meets DRC guidelines

Specific documentation guidelines can be accessed here: Documentation Guidelines

If available, please also include IEPs, 504 Plans or High School Service Plans, Letter of Accommodation from other colleges, and/or SAT/ACT Accommodation Approval Letters.

You can upload your documentation along with this application to our secure website, or, if you prefer, you can fax, mail, or hand deliver your documentation to our office. Our contact information is listed at the end of this message. You will also be provided with an opportunity to upload your documentation via email upon submission of your application.

3) Attend an initial interview with your assigned disability coordinator

After you submit your application, it will be reviewed by the intake coordinators. If we require additional information, we will contact you via your UGA email address. Once your application has been reviewed, you will be assigned to a disability coordinator who will contact you to set up an initial interview where you will discuss setting up accommodations.

You can complete this application at any time, although we encourage students to complete it as early as possible. Once everything is submitted, the process to evaluate the application takes around 1-4 weeks, so the earlier you submit the application, the earlier we can begin that process. All information provided to the DRC is confidential.

Directions for completing the Request for Services form:

NOTE: When completing the application, the page may time out. To keep this from occurring, please submit your answers often. This will not submit multiple applications.

Please answer all questions as completely as possible. Most questions are required, so if a question does not apply to you (e.g. diagnosis is not required to be shared for an Emotional Support Animal request), please either select “Not applicable” or write it in the space provided. If you require more room for written responses, the text boxes can be enlarged by hovering over the bottom right corner and resizing the box.

If you have any questions while completing this application, would like more information about our services, or require this application in an alternative format, please contact our office.

DRC Contact Information

Address: Clark Howell Hall, 825 South Lumpkin Street, Athens, GA 30602-3338
Phone Number: 706-542-8719
Fax Number: 706-542-7719
Email Address: drc@uga.edu
Personal Information
  1. Note: Select when you would like to start your services.
  2. Note: Select when you plan to graduate.
  7. Hint: Enter 9 alpha numeric characters.
  8. Hint: Enter date in the following format Month/Day/Year (i.e. 12/31/2010).
Contact Information
  1. Hint: Enter 10-digit number only.
  2. Hint: Enter 10-digit number only.
Local Address
  4. Hint: Enter zipcode as 97331 or 97331-0000.
Permanent Address
  4. Hint: Enter zipcode as 97331 or 97331-0000.
Additional Information
  2. Affiliation(s)
  3. Campus Location(s)

Questions

  1.  
    Current UGA Status * (Selection is Required)
  7.  
    Please list any academic accommodations and/or services that you used in high school, if applicable: * (Selection is Required)
  8.  
    Please list any colleges previously attended and any academic accommodations and/or services used there, if applicable: * (Selection is Required)
  9.  
    Please list any accommodations that you used on any national standardized exams (SAT, ACT, GRE, LSAT, etc.), if applicable: * (Selection is Required)
  11.  
    Do you live on or off campus? * (Selection is Required)
  12.  
    HOUSING: If you live ON CAMPUS, do you require residential housing accommodations? * (Selection is Required)
  13.  
    HOUSING: If you live ON CAMPUS, how does your disability affect you in a residence hall setting? * (Selection is Required)
  14.  
    HOUSING: If you are living ON CAMPUS, what specific housing accommodations are you requesting, if applicable? * (Selection is Required)
  15.  
    Please list any auxiliary aids, equipment, assistive technology, and/or other services you anticipate using while attending UGA: * (Selection is Required)
  16.  
    Do you need accommodations for any of the following? Please check all that apply:
  17.  
    I understand that my request for accommodations cannot be approved until all documentation is submitted and approved by the Disability Resource Center. Detailed eligibility criteria can be found on our website at the link listed in the instructions. Please select your chosen method of submitting your documentation below: * (Selection is Required)
  19.  
    By selecting yes, I am authorizing the Disability Resource Center to discuss my documentation with the clinician who authored the documentation, or other qualified personnel, should further clarification be required. * (Selection is Required)
  20.  
    By submitting this form, I certify that the information provided is correct. I understand that in order to be eligible for accommodations at the University of Georgia, I must (1) submit this completed form, (2) submit my disability documentation, and (3) complete an initial interview with a coordinator at the Disability Resource Center. * (Selection is Required)
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