Department for Disability Access and Advising Forms

  • Please download and complete the appropriate form, and return it to the Department for Disability Access and Advising (D2A2). If you have questions or need assistance, please contact our office at 724-357-4067 or disability-access@iup.edu

  • D2A2 Declaration of Disability (PDF)
    Please be aware that IUP does not discriminate against anyone because of race, gender, age, national origin, religion, sexual preference or disability in any of its educational programs or activities. We offer services which are provided by Section 504 of the Rehabilitation Act, and the Americans with Disabilities Act (ADA). To receive accommodations for a disability at IUP, you must enroll with our office even if you already receive services from the state Office for Vocational Rehabilitation (OVR) or Blindness and Visual Services (BVS). In this way we will work together to provide support services.
    D2A2 Declaration of Disability (.docx)
    MS Word version of the declaration of disability form
    D2A2 Formulario de Declaracion de Discapacidad - Español (PDF)
    Por favor esté conciente de que IUP no discrimina a nadie por su raza, género, edad, origen o nacionalidad, religión, preferencia sexual o discapacidad en ninguno de sus programas educativos o actividades. Nosotros ofrecemos servicios los cuales son proporcionados por la Sección 504 de Actos de Rehabilitación y la Acta de Americanos con Discapacidades (ADA). Usted debe inscribirse en esta oficina aunque ya reciba servicios de la oficina para ciegos y de servicios visuales (Bureau of Blindness and Visual Services – BVS) o de la oficina vocacional de rehabilitación (Office of Vocational Rehabilitation - OVR). De este modo trabajaremos juntos con el fin de brindarle los servicios de apoyo.
    D2A2 Formulario de Declaracion de Discapacidad - Español (.docx)
    Versión de MS Word
    Documentation of Disability - Attention, Psychological/Emotional, Health/Physical, Mobility (PDF)
    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.
    Documentation of Disability - Attention, Psychological/Emotional, Physical/Health, Mobility (.docx)
    MS Word version
    Documentation of Disability - TBIs & Concussions (PDF)
    Documentation of Disability Form (TBIs & Concussions)  This form may be used by IUP students to provide documentation for TBIs and concussions  This form excludes all other disabilities To Whom It May Concern: A patient/client of yours has requested disability support services from The Department for Disability Acces
    Documentation of Disability - TBIs & Concussions (.docx)
    MS Word version
    Test Request (PDF)
    Use this form to schedule an accommodated test within the D2A2 office. The form must be downloaded, completed (page 1 by student; page 2 by professor), and returned by the student to the D2A2 office (216 Pratt Hall, M - F 8am - 4pm) at least 3 school/business days in advance of the test (at least 5 school/business days in advance for finals week). Or, if you with to submit the completed form to D2A2 via email, you must complete page 1 of the form on your computer, save it to your computer with a different name, and then email it on to your professor (for him/her to complete page 2), asking that the professor then email the form back to you. Once the professor completes page 2 and emails it back, you (the student) must then forward it on to D2A2 by email at dss-test@iup.edu (at least 3 school/business days in advance of the test, or 5 school/business days in advance of finals week).
    Test Request (.docx)
    MS Word version
    Alt Text Request (PDF)
    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. Download, complete, and return the form to the D2A2 office. Or, if you choose to submit to D2A2 via email, download, complete the form on your computer, save the form with a new name, and then email the completed form to D2A2 at alt-text@iup.edu
    Alt Text Request (.docx)
    MS Word version
    Spring 2019 D2A2 SCHEDULING (PDF)
    This is the green Scheduling form for the Spring 2019 semester. Please download, complete, and return the form to D2A2. Or, if you wish to submit the form to D2A2 via email, please download, complete the form on your computer, save it with a new name, and then email the completed form to D2A2 at disability-access@iup.edu
    Spring 2019 D2A2 SCHEDULING (.docx)
    MS Word version
    Summer 2019 D2A2 SCHEDULING (PDF)
    This is the green Scheduling form for the Summer 2019 semester. Please download, complete, and return the form to D2A2. Or, if you wish to submit the form to D2A2 via email, please download, complete the form on your computer, save it with a new name, and then email the completed form to D2A2 at disability-access@iup.edu
    Summer 2019 D2A2 SCHEDULING (.docx)
    MS Word version