Intake Form

Use this form if it is your first time requesting services from the Disability Resource Center. You only need to complete this form one time. If you are already receiving services or have in the past, use the Request for Accommodation form.

General Information
Emergency Contact Information
Disability Information
Education and Academics
Enrollment Information
Have you applied for admission to BC?
Have you taken the BC Math Assessment?
Have you taken the BC English Assessment?
Optional Information
Which race/ethnicity do you consider yourself? (check all that apply)
Is English your second language?