Forms

Title of FormAdditional InformationLink to Form
Request for records or release of confidential information

Forms used to request copies of disability records or to authorize DASS to exchange information with a third party.

Email form to accommodations@csuci.edu

Request for Documents and Release of Information Forms
Disability Verification FormForm used to document disabilities, limitations and provide supporting evidence for requested accommodations. This form must be completed and signed by a licensed/certified professional qualified to diagnose and treat the condition.Disability Verification Form (PDF, 598KB)
Self-Report FormForm used to self-report disability and how the disability impacts your learning experience.Self-Report Form (PDF, 681KB)
Note Taking Express App How-to GuideGuide on how to use NTE App for uploading recordings.

Note Taking Express Guide (PDF, 444K)

Request for Waiver of Campus Parking FeesCampus parking fee waiver for students with disabilities who meet the eligibility standards based on the form.

Request for Waiver of Campus Parking Fees (PDF, 318KB)

Single Room AddendumTo be completed when a student requests an accommodation of a single room in housing.

Single Room Addendum (PDF, 492KB)

Support Animal AddendumTo be completed when a student requests an accommodation for an emotional support animal in housing.

Support Animal Addendum (PDF, 520KB)

Materials Permission FormTo be signed when student uses materials during an alternative test at DASS office.  Students consent to any possible consequences if this was not allowed during the exam.

Materials Permission Form ( PDF, 210KB)

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