Priority Housing Request Form

Campus *

Vancouver - Centre for Accessibility

Okanagan - Disability Resource Centre

To be eligible for priority access to UBC Student Housing, you need to demonstrate your requirement for on campus housing based on the functional impact of your disability or ongoing medical condition.
In order to be recommended for priority access, you must have disability-related needs that cannot be met in off-campus housing. A disability alone is insufficient to qualify for priority housing.
Priority access to housing on the sole basis of supporting mental wellbeing is typically not approved.
Prior to submitting your application, review our medical documentation guidelines. You will need this documentation when completing this form.
Review Room Types in advance.

To be eligible for priority access to UBC Student Housing, you need to demonstrate your requirement for on campus housing based on the functional impact of your disability or ongoing medical condition.
In order to be recommended for priority access, you must have disability-related needs that cannot be met in off-campus housing. A disability alone is insufficient to qualify for priority housing.
Priority access to housing on the sole basis of supporting mental wellbeing is typically not approved.
Prior to submitting your application, review our medical documentation guidelines. You will need this documentation when completing this form.
Review Room Types in advance.

I understand: *

Students must be in 9 on-campus credits per term, or be considered a full-time student, to live in Housing. *

Students must be in 9 on-campus credits per term, or be considered a full-time student, to live in Housing. Please consult with Disability Resource Centre if you are requesting to be in residence while taking fewer than 9 credits, or not considered a full-time student.

All students must adhere to the policies and regulations set out by Student Housing and Hospitality Services. *

All students must adhere to the policies and regulations set out by Student Housing and Hospitality Services.

Student Housing and Hospitality Services is a resource for general resident inquiries (room layouts, number of washrooms on a floor, etc) *

Student Housing and Hospitality Services is a resource for general residence inquiries (room layouts, number of washrooms on a floor, etc)

I understand: *

Students must be in 9 on-campus credits per term, or be considered a full-time student, to live in Housing. *

Students must be in 9 on-campus credits per term, or be considered a full-time student, to live in Housing. Please consult with Centre for Accessibility if you are requesting to be in residence while taking fewer than 9 credits, or not considered a full-time student.

All students must adhere to the policies and regulations set out by Student Housing and Hospitality Services. *

All students must adhere to the policies and regulations set out by Student Housing and Hospitality Services.

Placements are typically offered in year-round housing (students may be able to sublet in the summer) *

Placements are typically offered in year-round housing with occupancy starting in May or September (students may be able to sublet in the summer)

Student Housing and Hospitality Services is a resource for general resident inquiries (room layouts, number of washrooms on a floor, etc) *

Student Housing and Hospitality Services is a resource for general residence inquiries (room layouts, number of washrooms on a floor, etc)

Application Process:

Step 1: Submit your general residence application to UBC Student Housing & Hospitality Services by the requisite deadline

Step 2: Complete the priority housing form below

Deadline: February 15th for May or September occupancy date

Personal Information

Application Process:

Step 1: Submit your general residence application to UBC Student Housing & Hospitality Services by the requisite deadline

Step 2: Complete the priority housing form below

Deadline: February 15th for May or September occupancy date

Personal Information

Preferred first name *

Last name *

Pronoun

UBC student number *

Email *

Desired date of occupancy

Year

Month

Day

Medical documentation *

Documentation must address the functional impact of the disability specifically as it applies to housing needs.

I have already provided my medical documentation to the Disability Resource Centre for UBCO

Documentation is not available at this time (note: not uploading your documentation may result in a delay in registration with our office)

Upload

Medical documentation *

Documentation must address the functional impact of the disability specifically as it applies to housing needs.

I have already provided my medical documentation to the Centre for Accessibility

Documentation is not available at this time (note: not uploading your documentation may result in a delay in registration with our office)

Upload

Please explain *

Medical Documentation Upload *

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 accommodations.drc@ubc.ca and include your student number if applicable.

Medical Documentation Upload *

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.

Specific room requirements detail *

Private washroom

Connected single room (washroom shared with one other person)

Sole occupancy (i.e., nano, studio or one-bedroom unit)

Priority room transfer

Wheelchair accessible unit

Other:

Specify other room requirement: *

1. Rationale for requiring on-campus housing due to a medical condition or disability. *

2. My condition is *

Permanent

Temporary

i. Estimated recovery time *

Year

Month

Day

3. Where will you live if you don’t live on campus? *

4. Does your medical condition impact commuting? *

Yes

i. Describe *

5. Are there medical reasons you need to access your unit during the day? *

Yes

i. Describe *

In the event of an emergency *

No mobility issues nor assistance needed during an emergency

I would require assistance during an emergency

Please describe *

Disclosure agreement *

I provide staff of the Centre for Accessibility with consent for the release of relevant information from my file, to the extent necessary to evaluate this request. Subject to the laws of the province governing access to information (Freedom of Information and Protection of Privacy Act), the Centre for Accessibility will not release any identifying information about clients to any parties other than those involved in the provision of service.

Disclosure agreement *

I provide staff of the Disability Resource Centre with consent for the release of relevant information from my file, to the extent necessary to evaluate this request. Subject to the laws of the province governing access to information (Freedom of Information and Protection of Privacy Act), the Disability Resource Centre will not release any identifying information about clients to any parties other than those involved in the provision of service.

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.

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.

Leave this field blank

Application Process:

Personal Information

Application Process:

Personal Information

Please provide a disability-related rationale for on-campus housing and/or the placement request(s) listed above.