Housing Accommodation Interest Form

Housing Accommodation Interest Form
Name

First NameLast Name
UAlbany ID Number
Begins with 00 and is 9 numbers
UAlbany Email Address
PSwan@albany.edu
Are you currently registered or waiting on a registration meeting with DAISS at this time?

Please Make An Appointment with DAISS
If you are not currently registered with DAISS, you will be unable to apply for a housing accommodation approval. Request an Appointment by logging into Accomodate with your UAlbany credentials and click on Appointment then click Request New Appointment.

Disclaimer: Before answering the following questions, please be aware that all University Officials are considered mandated reporters. This means that any mention of crimes or incidents including but not limited to sexual assault, dating and domestic violence, or stalking must be reported to the University at Albany Office of the Title IX Coordinator
What is your diagnosed Disability?
Please describe how your disability impacts you.
Please be detailed in your response
In your own words, please describe why the chosen housing accommodations are medically necessary.
Please be detailed in your response.
How has living on campus been medically detrimental to your health/mental health?
Please be detailed in your response.
Should be Empty:

Please Make An Appointment with DAISS