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Suspected disability self-assessment form

This form enables you to begin the registration process with our office since you are suspecting that you have an undiagnosed and undocumented disability (e.g., a learning disability, ADHD, a mental health disability, and/or a disabling condition).

This form will assist our Clinical Records Evaluator in understanding your current academic difficulties, which may be because of a suspected disability. Based on the information provided in this form, and assessment during your Registration Appointment, you may be eligible for temporary academic accommodations while you seek to obtain appropriate supporting medical documentation.

Privacy Statement

Documentation submitted to this site is kept strictly confidential and will only be viewed and stored by AccessAbility Services. In accordance with Section 39(2) of the Freedom of Information Act, 1990 ("FIPPA"), the information within the form is collected under the authority of the University of Waterloo for the purpose of interim academic accommodation planning. All personal information collected will be used, stored, and destroyed in accordance with the University's Information Protection and Access Policy.

Information and privacy: questions regarding the collection of information on this form can be directed to the form administrator.