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Disability Support Registration Form

We value your privacy and we have a strong commitment to confidentiality.

The information you provide on this form will be kept within Disability Support. It will assist us to provide a prompt and personalised response to help ensure the right support is in place for your studies.

Information about the nature of your disability or medical condition will not be disclosed and will not appear on your academic records.

For more information please visit the confidentiality page.

Please complete all sections of the registration form.

NB: You will need to upload supporting medical documentation (Verification and Impact Statement or Psychological Assessment or medical reports) at the end of the registration form.

If you require assistance to complete this online registration form, please phone Disability Support on 08 8313 5962.

Disability Service Registration form
* Indicates Required Information

 

  • Section APersonal Details










  • Section BContact Information






  • Section CProgram Information

    *If you are a prospective student, please skip this section.







  • Section DDisability Information

    Please be assured that the information you provide on this form is only available to Disability Support.











    If "Yes," please upload any documentation of Year 12 provisions.







    If "Yes," please upload documentation of any special provisions or Access Plan.











  • Section EMedical Information & Documentation

    * Please note: • Documents must be scanned and not photographed. Scanning facilities are available at Hub Central • The maximum total file size for all of the documents attachments included in this form is 20MB, if the total is over that amount the form will not submit.

    For further information regarding scanning facilities, please visit Ask Adelaide.

    Please upload a scanned copy of all relevant information including;

      1. Verification and Impact Statement (to be completed by a relevant practitioner)
        Please download a copy of our VIS


      1. Psychological learning assessments and/or medical Certificates or reports


      1. Any other relevant medical documentation of your disability or medical condition from your medical practicitoner.

      1. Additional information


      1. Additional information


    If you are unable to provide your relevant documents, please outline the reason below:


    Additional information

    Please include any other relevant information in the box below:


Student Life
Disability Support
Address
Level 6, Hughes Building
North Terrace Campus
THE UNIVERSITY OF ADELAIDE
SA 5005 AUSTRALIA
Contact

 
T: +61 8 8313 5962
F: +61 8 8313 6463
disability@adelaide.edu.au