Student Accessibility Request Form "*" indicates required fields Your Name * RequiredYour PronounsYour Preferred Name * RequiredYour Phone Number * RequiredYour StarIDYour TechIDAre you a current PSEO or 91涩漫 Student?NoYesHave you been a prior college student?NoYesPrior College NameHave you used accommodations in High School or at a previous college/university?NoYesPlease list the accommodations you hadPlease identify the disabilities that impact you Learning Disability Autism Spectrum Disorder Traumatic Brain Injury Chemical Dependency (history of) Deaf/Hard of Hearing Systemic Impairment (other medical) ADHD/ADD Psychiatric Condition(s) Developmental Cognitive Speech Impairment Mobility Impairment Blind/Low Vision Describe your disability and how it impacts your learning or functioning on a day-to-day basisList any methods, tools or services you are currently utilizing to offset this impact, and if they are effective
