Student Accommodation Request Form (Non‐Disability)

Use this form to request a non-disability human rights related accommodation as per the Student Access to Accommodations Policy. Submit this form to

Please note that documentation related to your request may be needed. Any documentation of a personal or medical nature can be submitted to the Student Servies department, who will share (as appropriate) only information related to any functional restrictions or circumstances that require accommodation. The confidentiality of your personal and/or medical information will be safeguarded by the Student Services department in accordance with privacy regulations.


Student Information

Accommodation Details

Student Acknowledgement & Agreement regarding Confidentiality

I understand that the personal information related to my academic accommodation request, including any supporting documentation, shall be treated as strictly confidential, and shall not be disclosed to other persons without my consent. Information collected will remain separate from my student file. I understand that, in order to implement any academic accommodations, basic information may need to be shared with my instructor or others involved in the accommodation, only to the extent necessary and only with my consent.