Information Form

Personal Information

E.g. 6048222211

Additional Information

Medical Condition/Disability Information

Files must be less than 5 MB.
Allowed file types: jpg jpeg png pdf doc docx.

Note: If you have additional medical documentation to upload, please send it to accessibility.intake@ubc.ca and include your student number if applicable.

Note: If you have additional medical documentation to upload, please send it to accommodations.drc@ubc.ca and include your student number if applicable.

Please note temporary conditions (reasonably expected to recover) are not defined as a disability covered under the Centre for Accessibility or Disability Resource Centre. Contact your faculty or Faculty Advising Office.

Please connect with a healthcare provider before scheduling this appointment. Exception: students with a suspected Learning Disorder.

How does your disability/medical condition impact you in the following areas:

Privacy statement

Personal information you provide on this form is collected pursuant to section 26(c) of the Freedom of Information and Protection of Privacy Act ("FIPPA"). The information is used for the purpose of processing your request. Questions about the collection of this information may be referred to info.accessibility@ubc.ca.

Privacy statement

Personal information you provide on this form is collected pursuant to section 26(c) of the Freedom of Information and Protection of Privacy Act ("FIPPA"). The information is used for the purpose of processing your request. Questions about the collection of this information may be referred to drc.questions@ubc.ca.