Self-Disclosure and Accommodation Request Forms

To apply for services, please complete the Self-Disclosure and Accommodation Request Forms and submit them to the Disability Coordinator in SASSI.

Please note that included in the forms is a Release of Information Form that students should sign to allow SASSI to discuss the student’s needs with their medical provider and/or diagnostician and any offices from which they have previously received accommodations. While this release it not required in order to gain accommodations, it may be of significant help in determining appropriate accommodations.

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Student Academic
Support Services and Inclusion

8 S. Dunlap GEB, Rm BB9
Memphis, TN 38163
Phone: (901) 448-5056
Fax: (901) 448-1451

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