Disability Disclosure Form

Please only complete this form if you want to log your disability/disorder with the Office of Student Affairs and/or you are requesting accommodations for the upcoming Academic School year. If you have any questions when completing the form, please email student affairs@relay.edu.

 

Relay strives to create an inclusive and safe learning environment for all of our students. The Office of Student Affairs is here to help you to demonstrate the existence of an exceptionality which may entitle you to reasonable accommodations, services and supports under the Americans with Disabilities Act (ADA) and related laws. The information you submit on this form will be shared with the Office of Student Affairs who will then review your request and follow up with you as appropriate.


Please note that if you select "No Accommodations Required," you will not receive a follow-up request for a meeting as this indicates you are not in need of supports at this time.

 
 
 
 
 
 
 
 

 
 
 
 
 
 

that would prevent you from evacuating a building in an emergency?

 
 

Please note that at this time Relay cannot provide personal care attendants, personal readers/notetakers, or personal devices.

 

 

Medical Documentation

Relay Graduate School of Education is required to obtain documentation from a treating healthcare professional supporting your disability or disorder. Documentation from external sources may include educational or medical records, reports and assessments created by health care providers, school psychologists, therapists, teachers, or the educational system. This information is inclusive of documents that reflect education and accommodation history, such as Individual Education Program (IEP), and or relevant Section 504 Plans xii. The documentation should be a typed on letterhead: Dated within 12 months of today's date, State the disability or disabilities. Explains the need for the requested accommodations (If appropriate) Discusses the severity and/or expected progression (If appropriate) Lists potential side-effects of relevant medication (If relevant) Describes current and/or past accommodations and signed by a qualified professional. Please ensure that your document is 2MB or less. You may upload up to 3 documents. If your document(s) are too large, please email them directly to studentaffairs@relay.edu. Do not email any documents to instructors or professors. **You can continue to complete this form but please note that your missing documentation can delay the accommodations process and/or may result in the request being denied or voided. We would advise you set up a time to speak with someone in the Office of Student Affairs.

 
 

 

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