Intake Application

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Student Information

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Welcome to the Office of Accessibility Services Application Portal!


If you have an immediate access need related to a campus visit or orientation, please contact our office at 860-832-1952. 


To prepare for your Intake Meeting with an OAS Disability Specialist, please complete all applicable sections of the form below. Providing detailed information will help us better understand your needs and support you effectively.

Please use your university issued email address
Date of BirthRequired
Faculty, Parent, adviser, etc
Class Standing
Are you and Incoming transfer Student?Required
Are you a University Athlete?
Are you a military veteran?

Specific Medical Information

Temporary

Temporary impairments typically last 6 months
Are you requesting accommodations due to a temporary impairment?Required

Title IX

Conditions covered under Title IX may include: Pregnancy, Childbirth, Miscarriage, False pregnancy, Abortion, and/or recovery from these conditions.

Housing Accommodations

Reasonable housing accommodations may be available for CCSU students living on campus who complete the OAS registration process and are found eligible under the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act of 1973. Please note that students must also submit a separate housing application and deposit directly to Residence Life.

Are you requesting housing accommodations?Required

Meal Plan Accommodations

Central Connecticut State University’s (CCSU) standard meal plan policy requires all students living on campus to purchase a meal plan. CCSU offers several meal plan options, which can be viewed here: https://www.ccsu.edu/reslife/mealPlanOptions.html.


CCSU Dining Services also provides a variety of options for students with dietary needs and preferences, including vegetarian and vegan meals, allergen-free food items, celiac-friendly menu options, and other specialized dining accommodations. More information is available at:
https://ccsudining.sodexomyway.com/explore/nutrition.


Requests for an exception to the standard meal plan policy are considered on a case-by-case basis as an accommodation request. Students seeking this accommodation must register with the Office of Accessibility Services (OAS) and provide appropriate documentation supporting their request. Requests must be submitted each academic year and should be received at least 30 days prior to the first day of classes.

Are you requesting meal plan/dining accommodations?

Documentation

Documentation requirements vary depending on your diagnosis and the accommodations being requested. Please carefully review the information below and upload your documentation directly to Accommodate, if possible. Alternatively, documentation may be scanned and emailed in PDF format to accessibilityservices@ccsu.edu.


Please note that IEPs and 504 Plans developed in high school are helpful and will be reviewed as part of the Intake process; however, they are not alone sufficient documentation for determining eligibility for accommodations. 
If you have questions or concerns regarding documentation requirements, please contact the Office of Accessibility Services (OAS) at 860-832-1952 to speak with a Disability Specialist.

  • Learning Disabilities and/or Autism: A copy of most recent Educational, Psychological, Psycho-educational, Triennial, or Neuropsychological Evaluation. These evaluations are often completed during middle or high school and may be part of your special education record, which may be available through your high school special education office.

  • ADD/ADHD, Chronic Medical and/or Mental Health Conditions: An OAS  Medical Verification Form. Student completes page 1 only. Your licensed treating medical or mental health provider completes pages 2-5, or provides the equivalent documentation in written form, which must be signed and dated. For hearing impairments: A recent audiogram.

  • Pregnancy-Related Conditions: Written verification from your treating, licensed physician/midwife that includes your condition/diagnosis, due date, symptoms, severity of symptoms, and any current restrictions/activities to avoid. This document must be dated and signed by the physician/midwife and submitted on letterhead. Please note: this status is a protected class under Title IX. Relevant policies and procedures follow: Nondiscrimination and Title IX | Central; Final-Procedure-regarding-Pregnancy-and-Related-Conditions_May-1-2025.pdf.

  • Temporary Conditions or Injuries: Written verification from your treating, licensed physician or surgeon describing your condition/diagnosis, symptoms, severity of symptoms, treatment plan, prognosis, and any restrictions or activities to avoid. Documentation must be signed, dated, and submitted on official letterhead. Alternatively, the OAS Medical Verification Form can be used.

Do you plan on uploading documents today?

Accommodation History

Did you receive accommodations in high school?Required
Did you have an IEP or 504 plan?Required
Did you receive accommodations at another institution of higher education?Required
Registration for servicesRequired

Are you registered with a Department of Rehabilitation Services or Bureau of Educational and Services for the Blind?

Please list any relevant community agencies or campus resources that you are currently utilizing.

Please list other resources/supports you feel that you may need a referral to on campus, or in the community.

Confidentiality StatementRequired

The Office of Accessibility Services (OAS) maintains the confidentiality of students’ disability/impairment records in accordance with the Family Educational Rights and Privacy Act (FERPA). All records are securely maintained. Information regarding a student’s disability and accommodations is shared only with university personnel who have a legitimate educational need to know in order to coordinate approved accommodations. Disability-related information is not noted on a student’s academic record or transcript.

In accordance with FERPA, disability documentation will not be released to individuals outside the University without the student’s written consent, unless permitted or required by law. Students have the right to review their OAS records with a Disability Specialist by submitting a Request to Review My Records Form.


Central Connecticut State University (CCSU) is committed to providing equal access for students with disabilities in accordance with applicable state and federal laws, including the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act. 
Reasonable accommodations are determined through an interactive Intake Meeting and are based on the student’s self-report, a review of relevant documentation, and an individualized assessment of accommodation needs.