Disability Support Registration Form

Thank you for choosing to register with Disability Support. Please complete all relevant sections of the registration form below.

Note: You will need to upload supporting medical documentation (i.e. Verification and Impact Statement (VIS); or current Adult Learning Assessment if you have a Specific Learning Disability) at the end of the registration form, so please have these available prior to completing this form.

Time frames to organise support - We understand it may take you time to obtain or get copies of relevant supporting medical documentation. During peak periods, there may also be delays of up to 2-3 weeks to book an appointment to see a Disability Advisor once you have registered. Therefore we encourage you to register with our service as soon as you enrol in your courses.

If you need support once the semester has commenced, and you are waiting for an appointment to see a Disability Advisor, the University has other processes you can use in the interim to get the support you need.

Extensions on assignments – please use the Modified Arrangements for Coursework Assessment (MACA) policy - Application for Assessment Extension form. This will need to be completed by your health practitioner and submitted to your Course Coordinator prior to the due date of an assignment.

Not able to sit a test/exam on the scheduled date due to significant illness or injury -  please use the Modified Arrangements for Coursework Assessment (MACA) policy - Application for Replacement Examination form. This will need to be completed by your health practitioner and submitted to your Faculty. There are tight time frames for applying so please refer to the policy for details.

Missed a class – please contact your Course Coordinator/ Tutor on the same day to ask if they will require a medical certificate to cover your absence.

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

Personal details

Please indicate if you are a current or prospective student

(Date format: DD/MM/YYYY)

Are you:

Country of citizenship

Contact information

NB: This will be the main communication channel.

Program information

Enrolment status

Disability/medical information

Please be assured that the information you provide on this form is only available to Disability Support.
Did you have special provisions in Year 12?
Please upload any documentation of Year 12 provisions.
One file only.
20 MB limit.
Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.
Have you previously studied at a tertiary institution?

Please upload documentation of any special provisions or Access Plan.
Unlimited number of files can be uploaded to this field.
20 MB limit.
Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.

Please indicate the services you are seeking assistance with:

Medical information & documentation

Please scan documents, rather than providing photographs where possible. Scanning facilities are available at Hub Central, or visit Ask Adelaide for more information.

Unlimited number of files can be uploaded to this field.
20 MB limit.
Allowed types: gif, jpg, jpeg, png, odf, pdf, doc, docx.

Unlimited number of files can be uploaded to this field.
20 MB limit.
Allowed types: gif, jpg, jpeg, png, odf, pdf, doc, docx.

Unlimited number of files can be uploaded to this field.
20 MB limit.
Allowed types: gif, jpg, jpeg, png, odf, pdf, doc, docx.

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

Disability support student agreement

Disability Support provides confidential and professional support to current students.

By registering with Disability Support, I understand that:

  • Details of my medical condition provided in my online registration, and supporting medical documentation will be stored confidentially and only be available to staff within Disability Support
  • Only the impact of my condition on my studies (not my diagnosis) will be included in my Access Plan and/ or Alternative Exam Arrangements
  • The University is required to provide de-identified data to the Department of Education Skills and Employment (DESE) about:
    • The number of enrolled students with disabilities, and
    • The broad categories of disabilities (e.g. medical, physical, vision, mental health)

In order to prepare these reports only staff who are approved by the Director of Student Life), as well as critical university technical staff (ITDS) responsible for the maintenance and development of the university’s relevant systems, will have permitted access to relevant student data (not my personal health information).

Agree with disability support student agreement