Department for Disability Access and Advising Forms

Declaration of Disability form 

IUP does not discriminate based on race or ethnicity, gender identity, age, national origin, religion, sexual orientation, or disability in any of its educational programs or activities. We provide services commensurate with Section 504 of the Rehabilitation Act and the Americans with Disabilities Act. Register with this office even if you are working with Blind and Visual Services (BVS), the Office of Vocational Rehabilitation (OVR), or the Labyrinth program already, as we will work together to provide you with support services, as we are the designated department to provide IUP disability-related accommodations. Please download and complete this form, save it under a new name, and email it to us at disability-access@iup.edu 

Declaración de Discapacida formar (Español)

IUP no discrimina por motivos de raza o etnia, identidad de género, edad, origen nacional, religión, orientación sexual o discapacidad en ninguno de sus programas o actividades educativas. Brindamos servicios acordes con la Sección 504 de la Ley de Rehabilitación y la Ley de Estadounidenses con Discapacidades. Regístrese en esta oficina incluso si está trabajando con Blind and Visual Services (BVS), la Oficina de Rehabilitación Vocacional (OVR) o el programa Labyrinth, ya que trabajaremos juntos para brindarle servicios de apoyo, ya que somos los designados. departamento para proporcionar adaptaciones relacionadas con la discapacidad IUP. Descargue y complete este formulario y envíenos un correo electrónico a disability-access@iup.edu

Documentation of Disability form (attention, psychological/ emotional, health/ physical, mobility)

This form may be used to provide documentation for the following types of disabilities: Attention, Psychological/Emotional, Health/Physical, and Mobility. This form excludes Specific Learning Disabilities, Traumatic Brain Injuries, Vision Impairments, and Hearing Impairments. Please have your evaluator download and complete this form, and email it to us at disability-access@iup.edu 

Documentation of Disability form (TBIs and concussions)

Documentation of disability form for traumatic brain injuries and concussions. Please have your evaluator download and complete this form, and email it to us at disability-access@iup.edu 

D2A2 Services Request forms

Request forms for D²A² services. Please download and complete the appropriate form below (according to semester), save it under a new name, and email it to us at disability-access@iup.edu.

• Summer 2020 services request form
• Fall 2020 services request form

Alternate Format Text Request form

Please submit this form after it has been determined that audio or alternate format tests are an accommodation that you have been made eligible to use. Please download and complete this form, save it under a new name, and email it to us at alt-text@iup.edu.

Test Request form

Use this form to schedule an accommodated test/quiz within the D²A² office, or to request an online test/quiz to be proctored virtually (online) by D²A².

The form must be completed (page 1 by student; page 2 by professor) and returned by you (the student) to the D²A² office at least three school days in advance of the test/quiz (or, at least five school days in advance of midterm or final exams).

You may submit a hard copy version of the completed form in person to the D²A² office (216 Pratt Hall). Or, if you wish to submit a digital version of the completed Test Request form to D²A² via email, you should complete page 1 of the PDF fillable form on your computer, save it under a new name, and then email it on to your professor (for them to complete page 2). Ask the professor to then email the completed form back to you (the student). Once you receive the completed form from your professor, you (the student) must then forward it to D²A² by email at dss-test@iup.edu