Service Forms

UCLA The Hill

Available Service Forms

To initiate services, students should complete the Service Request Form.  If you prefer to complete it manually, a printable Service Request Form is also available.

Forms to receive service:

1 - Housing Accommodations Request Application

2 - Medical, Mobility, and Physical Disabilities Verification of Disability Form

3 - Parking Disability Verification Form

4 - AD/HD - Psychological Disability Verification Form

5 - Learning Disability Questionnaire

6 - Psychological Disability Questionnaire

7 - Gluten Free Pantry Request Form

Forms for CAE Registered Students:

8 - Request for Alternative Format

Please note: If there has been a change in the disability over time, especially since the initial diagnosis, the CAE will request documentation that reflects the current functional limitations. This is necessary to determine the most appropriate accommodations.  This may also mean requiring documentation on a yearly or quarterly basis for disabilities that inherently change over time.

Forms 09/28/2017