New Student Accessibility Request

* indicates a required field

Student Information

Students should enter this information themselves. Parents, guardians, or others may assist, but it is important that students provide their own information on this form.
Name you have registered in SUNY Cortland's systems
Name you have registered in SUNY Cortland's systems
If different than above, what would you like us to call you?
Please use your SUNY Cortland email address. Emails from our office will only be sent to your SUNY Cortland email address.
Would you like to opt-in to receiving appointment reminders via text message?Required

Specific Accessibility Information

Why are you contacting Disability Resources?Required

Does your request include housing? Please select "yes" if requesting an assistance animal or if your request involves residential living in any way.Required
Are you affiliated with ACESS-VR?Required

Information Sharing

The Family Educational Rights and Privacy Act does not permit our office to release or discuss your academic record with third parties except where we are required or allowed by law, or when you provide permission. Please note below if you grant us permission to share information with your parent, guardian, or someone else not affiliated with SUNY Cortland. Students may revoke this permission at any time.
I grant permission to share information with specific individuals outside of SUNY Cortland.Required
Supporting documentation is not required to submit this form. However, it may allow us to better understand your disability and the barriers that a college environment might create. It can allow us to craft the most appropriate access plan possible so those barriers are eliminated or minimized.Required