Request For Services Application

First Name required

Last Namerequired

Pronouns

She, Her, Hers

He, Him, His

They, Them, Theirs

If other, please indicate below

Other Pronouns

If you have pronouns other than those listed above, please indicate them here.

Phone Numberrequired

Email Addressrequired

Please use your Fisher College email address if available. (student@fisher.edu)

Enrollment StatusrequiredCheck all that apply

I am an incoming first year

I am an incoming graduate student

I am a visiting student

I am a prospective student

I am an incoming online student

I am an incoming transfer student

I am a current student

Check all that apply

Are you studying abroad?required

Yes

No

Tell us About Yourself

Briefly describe why you are contacting accessibility services?required

Tell us why you are reaching out

Are you seeking housing accommodations?

Yes

No

What is your formal diagnosis?required

Please describe your disability or disabilities and how it has affects you?required

Are you deaf or hard of hearing?

Yes

No

Have you ever received accommodations from another school?

Yes

No

Are you currently in therapy?

Yes

No

Are you currently taking any medications?

Yes

No

Have you ever received accommodations for standardized testing?

Yes

No

When was the most recent evaluation of your condition and who conducted the evaluation?

To see Fisher College documentation guidelines - please click below:

Fisher College Documentation Guidelines

File Upload

Attach up to 1 file with a maximum size of 10MB

No file chosen

Academic Information

Describe how your disability currently impacts your academic life.

In which courses are you usually most successful? Which give you more difficulty?

Which aspects of learning do you find the most challenging?

(i.e. Reading, paper writing, organization, note-taking)

Please list any Fisher College resources you have utilized

(Ex. WASC, Student Health Services, Career Development Center, Counseling Services)

Academic Accomodations Requested

Please list the accommodations that you feel are necessary to allow you to access our curriculum and community.required

Please describe how each accommodation relates to your disability.

Do you have or have you used any adaptive technology or devices? If so, please describe what has been the most helpful.

Other Information

Do you currently live in Fisher housing?

Yes

No

Are you a student-athlete?

Yes

No

Other Important Information: required

I am a client of vocational rehabilitation

I am an active service member or veteran

I am an international student

I am on academic probation

I am or a member of my family is a Fisher College employee

I am returning from a leave of absence

None of the above

Please include anything else you would like the Office of Student Accessibility Services to know in order to best assist you

Please list any questions you have about our services that we can answer for you

Policies and Procedures

Please Read Below are the general polices of the Office of Student Accessibility Services office at Fisher College (OSAS) Please read and type your name in the box below. I understand that:

It is my responsibility to provide accurate and timely documentation to OSAS.

It is my responsibility to check my E-mail for updates and announcements.

Once my documentation is in and I have had an initial meeting with OSAS staff, the process can take up to two weeks to be completed.

It is my responsibility to request accommodations each semester.

I must notify OSAS if I drop or add classes.

It is my responsibility to print and deliver my accommodation letters to my professor in a timely fashion.
If I am requesting a new accommodation, I must provide updated documentation and meet with a staff member
It is my responsibility to communicate directly with my faculty regarding exam accommodations, and stay in communications about the time and place of such exams.
It is my responsibility to contact Office of Student Accessibility Services (OSAS) in a timely fashion if I am having any difficulties in securing or arranging accommodations.
I am responsible for the condition and timely return of any equipment I use or borrow from OSAS.
If I am approved for Notetaking or Audio recording services, I understand that the notes and/or recordings are for my use only and may not be shared. In addition, I understand that I will only receive these services when I am present.
Requesting accommodations does not mean I have been or will be approved.
Some accommodations may be approved temporarily. This may be due to insufficient documentation and/or type of disability. In these cases, I will need to update my documentation to receive accommodations again.
OSAS does not provide retroactive accommodations.
Faculty are not required to provide any accommodation that fundamentally alters the nature of their course or lowers their academic standards.
Faculty are not required to provide any accommodation without receiving a paper copy of your Faculty Accommodation Letter at least one week in advance of a quiz or exam.
It is my responsibility to ask the professor of record whether other professors or academic personnel (such as course coordinators or teaching fellows) need to be informed of my approved for accommodations. It is also my responsibility to inform those professors as well.
Failure on my part to carry out any of these responsibilities may result in my inability to secure accommodations.

Add your name below to show that you have read, understood, and agreed to the policies of OSASrequired

Thank you for completing this form. If you haven't yet, please contact us at 617-670-4429 to schedule an intake appointment or use the acuity scheduling calendar.

For students who are Deaf or Hard of Hearing, please email us at fphillips@fisher.edu.