Forms

We have several forms available for download: They are PDF files which uses Adobe Acrobat Reader software, which can be downloaded free. Follow this Adobe Acrobat Reader software link if you require this free software.

Please use Adobe Acrobat 7 or later for viewing and printing these files.

Forms for UCLA Students:
1 - Disabled Students Housing Appeals Forms
2 - Verification of Disability Form
3 - Parking Disability Verification Form
4 - AD/HD - Psychological Disability Verification Form
5 - Learning Disability / Attention Deficit (Hyperactivity) Disorder Screening Questionnaire
6 - Psychological Disability Questionnaire
7 - Gluten Free Pantry Request Form

Forms for Registered Students:
8 - Request for Alternative Format
9 - Request for a Classroom Notetaker
10 - Request for Law School Notes. Please call the OSD office during business hours, (310) 825-1501, if you need assistance with this form.
11 - Proctor Request Form. To finalize your proctoring service registration for the Winter 2013 quarter, please bring your completed Proctoring Service form to the Proctor Service Center, located in room A-242 of Murphy Hall.  Please note that you must consult with a Proctoring Service representative to finalize your proctoring accommodations. You can receive a copy of the form in Murphy Hall room A-242.

Forms for Service Providers:
12 - Application to be a Classroom Notetaker
PLEASE NOTE: this form is meant to be emailed from your computer. When you hit Submit by Email a Pop-up box should ask you to select your email client. Use Desktop Email Application if you use Microsoft Outlook, Eudora, or Mail. Use Internet Mail if you use your browser to get to your email. When you click OK your email program should start or a Save As dialog box should open, save the PDF and mail the completed form to notetaker@saonet.ucla.edu
If the Select Email Client dialog box DOES NOT Pop-Up you will need to reset this on your computer. Close your browser. Start Abobe Reader, under Edit, Preferences, General look for Warnings and unselect the Do not show edit warnings checkbox and try again.