Request for Accommodation Form

Use this form to request services, but only if you have already completed an intake form. This form needs to be completed each academic quarter in which you need accommodations. Please complete all fields.

General Information
Do you need an appointment?
Would you like to schedule a meeting with a DRC counselor to discuss your accommodations or update your information for this quarter?
If yes, how should we contact you to set up this appointment?
Financial Services

Check all that apply:

Financial Services Contact Information
Update Your Personal Information
Emergency Contact Information
Update Your Academic Information
Campus Programs and Services

Check all that apply:

Club of Champions
Would you like information about the Club of Champions, a club for students with disabilities?

Please obtain a copy of your class schedule. Schedules can be retrieved on the BCC website, or at the student kiosk at the Student Services Center next to the bookstore.

Allow a minimum of 48 hours for your request to be processed.