New Student Intake Form - Ridgetown Campus Getting Started

This form is used to help determine whether Student Accessibility Services (SAS) is the right service for you, and when appropriate, help connect you with a SAS advisor. SAS only supports students who been admitted to the University of Guelph through Admission Services and who have a disability. Local services are also available through SAS at the Ridgetown campus.

First Name *

Last Name *

Preferred Name

Date of Birth *

UofG Email Address (if known, otherwise use your personal address)

Student Number *
This is a 7-digit number and starts with 0 or 1

Primary Contact Number *
Format: 555-555-5555

Alternate Contact Number
Format: 555-555-5555

Disability Information

We acknowledge that the term "disability" makes some people uncomfortable and we use it specifically with regards to protecting your rights and connecting you with the appropriate resources. You have many strengths and abilities!

Confirmed by healthcare professional *
Has a health care professional provided you with a diagnosis related to your disability?

Yes

Please check one or more of the following to describe your disability. If you checked more than one disability, please indicate the ONE which has the greatest impact on your learning in the box below:*

Any other disability not listed above

Hospital or emergency care *
Have you recently been in the hospital or received emergency care related to your disability?

Yes

Academic Standing

Student Status *
Please choose one of the following statements

Future student: not yet admitted to UofG

New Student: first year on campus

Continuing student but new to SAS

Absence from school *
Have you recently experienced an absence of 2 weeks or more from school for disability-related reasons?

Yes

Academic Deadline *
Do you have a pressing academic concern that requires attention in the near future?

Yes

Previous semesters *
Have you failed courses or are you on academic probation as a result of your disability?

Yes

Outstanding courses *
Do you have any deferred exams or incomplete coursework from a previous semester?

Yes

Resources

Accommodations Prior to UofG *
Did you receive accommodations in high school or at another post-secondary institution?

Yes

Counselling at UofG *
Have you used Counselling Services at the U of G in relation to your disability?

Yes

Coordinating Services

Student Accessibility Services (SAS) is a part of a larger department called Student Wellness and while SAS maintains separate student files, relevant information may be shared between units for the purposes of coordinating services (e.g. with Counselling Services and Health Services). I grant permission for professionals involved in my care to give and receive information for this purpose.

NOTE: This permission can be revoked at any time by contacting SAS in writing.

Yes

Current Functioning

Impact on Learning or Daily Living *
Please give a brief description of your disability and how it impacts your learning or daily living at university.

Current Academic Concerns *
What are your academic concerns related to your disability?

Temporary Situation
If this is a temporary situation, what is the expected duration?

Documentation

To protect the integrity of a rigorous academic environment, we require documentation verifying the existence of a disability from a registered health professional who is authorized to make a relevant diagnosis. Please visit our documentation guidelines for full details.

Documentation Available *