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Forms

The AccessAbility Center/Student Disability Services (AAC/SDS)
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Forms



Forms Description
Application for Accommodations and Services For students with disabilities seeking to register with The AccessAbility Center/Student Disability Services and receive accommodations, please complete the application and bring accompanying disability documentation from your provider to NAC 1/218 during the business hours.  Ideally, it is best to visit this Website and read through the instructions, or click here for a PDF version of the instructions.   
Accommodation Memo Request Form Each student who registers with the AAC/SDS completes an Accommodation Memo Request Form at the start of each semester to then be submitted to AAC/SDS (either in-person or electronically: disabilityservices@ccny.cuny.edu). Within two days of the submission, AAC/SDS front desk staff will generate your memos and send them to you via email; please note, you must forward the memo to your respective professor, in order for your accommodations to be coordinated and implemented during the semester.  Each memo indicates the pertinent disabilty laws that apply to public postsecondary institutions, a confidentiality statement, a list of your accommodations and services, and contact information of your assigned counselor. Students chose to whom they disseminate their memos to, but should be aware that without proper and timely notification, accommodations and services may not be implemented effectively.  
Request for Disability Documentation Provider Form If you have new accomodation and service requests, please bring the Request for Disability Documentation Provider Form to your provider to fill out, and then return the completed form to the AAC/SDS Office.  You will be scheduled for a follow-up appointment to discuss the new information and the request being made.   
Authorization for Release of Information When students register with AAC/SDS, AAC/SDS staff are able to disclose information on a "need-to-know" basis as it relates to providing access at the College. Your clinical and educational records are kept confidential. If you would like your assigned counselor to discuss your clinical and educational records, you will need to complete an Authorization for Release of Information that allows the counselor one year from the date it is signed to address with the named provider/professional/person your clinical and educational records.
Exam Accommodation Form If you receive exam accommodations, for each exam please complete the Exam Accommodation Form along with your professor, and return it to the AccessAbility Center at least a week in advance of your scheduled quiz or exam.  Timely notice is vital in order for AAC/SDS to make appropriate arrangements to administer your exam with accommodations. The professor will then submit the exam to AAC/SDS to administer and proctor.  If you have inquiries, please email: AccessAbilityExams@ccny.cuny.edu.  Disability Accommodation Specialist, Marie Ortiz (telephone: 212-650-5061, email: mortiz2@ccny.cuny.edu) is the Exam Administrator for AAC/SDS.   
Note-Taker Request Form This is provided to students with disabilities who require a note-taker in the classroom, which is determined during the student's intake, or if the student's disability status changes at any time and requires this service. Please complete the Note-taker Request Form each semester, and submit it via email: Notetaking@ccny.cuny.edu, or drop it off in-person at NAC 1/218.
ADA PT TAP If you are a part-time student with a disability and believe you may qualify for NYS TAP, please schedule an appointment with your assigned counselor who will provide assistance.  You can visit the New York State Higher Education Services Corporation (click link on left).