310 Lavery Hall (MC 0185)

430 Old Turner Street

Blacksburg, Virginia 24061

Ph: (540) 231-3788 Fax: (540) 231-3232

www.ssd.vt.edu; ssd@vt.edu

Student Information and Academic Accommodation Request Form

Revised: 03/31/2021 2:57 PM

Reasonable accommodations are available for students with disabilities to ensure equal access in

University life. Students may submit a reasonable accommodation request at any time, year-round.

However, students are encouraged to contact SSD as soon as they are aware of their need for reasonable

accommodations to ensure adequate time for arranging and implementation.  

Note: If you are requesting Campus Housing Accommodations, then start here:

https://ssd.vt.edu/accommodations/Housing_Accommodations.html

How to Apply for Academic Accommodations

1. Complete the Academic Accommodation Request Form, below. *If you are an individual with a disability and need to request an accommodation to complete this form, please contact us with your request at ssd@vt.edu or 540-231-3788.

2.Submit the completed request form, and any supporting disability documentation if available.

(Note: You may submit your request without disability documentation).

By Direct Upload (preferred method): Enrolled students with 2-factor authentication may use the

Online Student Health Portal (OSHP) for students. You may upload request forms and

supporting documentation directly to SSD by selecting “Disability Documentation” on the upload

webpage. Start the upload process in OneCampus:

https://onecampus.vt.edu/task/all/schiffert-online-health-portal.

By Fax: 540-231-3232

• By U.S. Mail (or courier services):

Services for Students with Disabilities (0185)

Lavery Hall, Suite 310, Virginia Tech

430 Old Turner Street

Blacksburg, VA 24061

3. SSD will confirm, by email, the receipt of your submission and provide information on your next

steps. Please check your Virginia Tech email account.

SSD is available to answer questions or assist you during regular business hours, Monday through Friday,

8:00 AM – 5:00 PM. Returning students may contact their disability counselor for further assistance.

Prospective and incoming first-year students may call SSD at 540-231-3788 or email ssd@vt.edu.

310 Lavery Hall (MC 0185)

430 Old Turner Street

Blacksburg, Virginia 24061

Ph: (540) 231-3788 Fax: (540) 231-3232

www.ssd.vt.edu; ssd@vt.edu

Student Information and Academic Accommodation Request Form

Revised: 03/31/2021 2:57 PM

Expedited Process for Academic Accommodations

Students who have accessed similar academic accommodations in a prior setting may select an expedited

review, when available, of their request for these specific accommodations: Extended Time for

Assessments, Reduced Distraction Assessment Environments, Note-taking Assistance (audio recording of

lectures, advance accessible electronic copies of all in-class materials, access to a smart pen, access to

note-taking software) or Priority Course Registration accommodations.

Students must submit their Academic Accommodation Request Form and third-party disability

documentation or documented prior use of accommodations (e.g. IEP, 504 Plan) for consideration.

Approved accommodations will be issued to the student within 5 business days of the request. All other

requested accommodations will be reviewed as usual and the student will be invited to attend a scheduled

appointment with their disability counselor.

Students without disability documentation or IEP/504 Plan are invited to submit their Academic

Accommodation Request Form. They will be scheduled to meet with their designated disability counselor

to discuss their accommodation request.

Each student will receive an SSD email confirming receipt of their accommodation request, and

information about their next steps.

Please respond to all items and indicate on the form if you want consideration for the Expedited Process, if

it is available.

310 Lavery Hall (MC 0185)

430 Old Turner Street

Blacksburg, Virginia 24061

Ph: (540) 231-3788 Fax: (540) 231-3232

www.ssd.vt.edu; ssd@vt.edu

Student Information and Academic Accommodation Request Form

Revised: 03/31/2021 2:57 PM

***Read the following instructions and answer all items.

To save this form with your data, you must PRINT to PDF.

Submit your form, and supporting disability documentation, if available, as PDF or images, to SSD.

Use the Secure Upload through the Schiffert Online Health Portal, as “disability documentation.”

START the upload process in OneCampus: https://onecampus.vt.edu/task/all/schiffert-online-health-portal.

Contact SSD@vt.edu for assistance.

Today’s Date:

Your Full Name:

Your preferred name or nickname: Cell phone number:

Your personal pronouns (He/him, She/her, They/them, etc.):

@vt.edu VT Hokie Passport ID (last 4 digits): VT email:

Your college: First year student? YES NO Transfer student? YES NO

Academic Level at Virginia Tech:

Are you a Virginia Tech student athlete? YES NO If YES, who is your SAASS advisor?

Are you in the Corp of Cadets? YES NO If YES, are you in the ROTC? YES NO

Are you a current client of any agency? List any other agency:

Have you been diagnosed with a disability or disabilities? YES NO

If YES, please state your disability or disabilities:

Have you received similar accommodations in a prior setting (high school, other college, etc.)? YES NO

Do you have an IEP, 504 Plan, school letter or third-party disability documentation in support of your request

for accommodations? YES NO

If available, I want to be considered for the Expedited Process for academic accommodations: YES NO

Note: The Expedited Process requires submission of an IEP, 504 Plan or school accommodation letter and this completed form.

Additional items may be addressed with your disability counselor.

310 Lavery Hall (MC 0185)

430 Old Turner Street

Blacksburg, Virginia 24061

Ph: (540) 231-3788 Fax: (540) 231-3232

www.ssd.vt.edu; ssd@vt.edu

Student Information and Academic Accommodation Request Form

Revised: 03/31/2021 2:57 PM

Please check or list the academic accommodations that you are requesting:

Priority Course Registration

Extended Time for Assessments

Reduced Distraction Assessment Environments

Audio recording of lectures

Access to Note-taking Software

Access to a Smart pen

Advance accessible electronic copies of all in-class materials

Other accommodations requested (please list):

PRINT to PDF and submit to SSD per the instructions on page 1.

Remember to upload your disability documentation, IEP, 504 Plan if it is available.

Thank you!

Note-Taking Assistance

Assessment accommodations:

Additional accommodations will be addressed with your disability counselor.