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Forms and Guidelines

List of DSS Forms and Guidelines with Descriptions
Form NameDescription
ADD/ADHD Verification FormCompleted by a professional who is trained and qualified to document this condition
Alternate Media ContractCompleted and submitted by a student after alternate media has been approved as a disability-related accommodation, which indicates that the student agrees to secure this information with regard to copyright restrictions of reproduced materials.
Alternate Media RequestCompleted and submitted online by a student when requesting alternate media as an approved disability-related accommodation. Students will also need to provide specific information on their textbook(s) and proof-of-purchase.
Academic Accommodation Request FormReturning SSU students, who are currently registered with DSS, may request accommodations online.
Accommodated Test Instruction (blue test form)Faculty may submit their exam and the instructions for administering this accommodated exam by the DSS office.
Accommodation Appeal FormStudents who have been denied their requested accommodation(s) may request reconsideration of the decision by completing the Accommodation Appeal/Reconsideration Form.
Adaptive Furniture GuidelinesGuidelines for the use of adaptive classroom furniture owned by DSS
Student Audio Recording and Transcription Services AgreementDSS Student Audio Recording and Transcription Services Agreement Form to be completed before a student is permitted to use a recorder or captioning services in an academic setting when recording/transcripts of material is necessary to provide reasonable accommodations for a documented disability.
Concussion Management Accommodation RequestA student who has sustained a concussion may request accommodation services through DSS related to this temporary condition.
Consent for DSS to Obtain InformationA student may provide DSS with consent to obtain records from another organization or professional, or a student may request that DSS send the appropriate disability verification form to their professional for completion.
Consent for Release of InformationA student may provide consent for DSS to speak with another individual or the student may request copies of their own records.
If a student would like his/her documentation released to an outside entity, then this request must be made directly to the professional who authored this report.
Dietary Accommodation RequestCompleted by a student and a qualified professional to document food allergies and special dietary requirements, including specific recommendations.
Exacerbation in Symptoms Accommodation Authorization Guidelines

This accommodation is intended to accommodate students with disabilities who may experience periods of exacerbated symptoms associated with their disability, which may necessitate recurrent absences, and where there will be periods of reduced symptoms.

Health Provider Verification For Housing AccommodationsStudents who request disability-related housing accommodations must have a professional who is trained and qualified to document this condition, complete this form online.
Housing Accommodation Request FormStudents may request disability-related housing accommodations if their functional limitations would otherwise prevent equal access to on-campus housing. After submitting your request please have a professional who is trained and qualified to document this condition.
Interpreting and Captioning GuidelinesStudents who are deaf or hard-of-hearing may request interpreting and/or real-time captioning services.
Learning Disabilities GuidelinesThe California State University Guidelines for the “Assessment and Verification of Students with Learning Disabilities” outlines the essential requirements necessary for documenting a learning disability.
Medical Verification FormThis form may be completed by the student’s health care professional related to medical conditions other than ADD/ADHD, Psychological, learning disabilities (see other specific verification forms).
Note-Taking Accommodation GuidelinesNote-taking services are provided as a disability-related accommodation to eligible students registered with the Disability Services for Students (DSS) office who have a documented disability, which impacts the student's ability to effectively take notes in class.
Psychological & Neurological Disabilities VerificationCompleted by a professional who is trained and qualified to document this condition.
Reporting ConcernsDSS welcomes any suggestions for improvement of services that will enhance the provision of our services to DSS students.
Student Information FormStudents begin the process of registering for DSS services by completing and submitting the Student Information Form (Intake).
Temporary Disability Accommodation RequestA student who has sustained a temporary disability/injury may request accommodation services through DSS related to this temporary condition.
Temporary Disability Parking ApplicationIndividuals who have sustained an injury impacting their mobility may request a 30-day temporary parking permit allowing the individual to park in spaces on campus designated for Disabled Persons (daily or semester parking permit also required).
Temporary Disability Parking GuidelinesThese guidelines outline the process and conditions for accessing and utilizing the 30-day Temporary Disabled Parking Permit.
Testing Accommodation GuidelinesThese guidelines outline the process and conditions for taking accommodated exams in the DSS office.