Student Accessibility Center Registration Form

* indicates a required field

Student Information

This form is for students who are requesting initial accommodations. The form MUST be completed by the student.

Timeline: Applications are processed in the order received. Students should expect to receive an email invitation from to schedule an initial appointment after the application has been processed.

Documentation: Please submit documentation via this form, email, or fax 773-508-3810. Please see our documentation guidelines before submitting your registration form.

Appointments: Appointments will be scheduled via Zoom unless otherwise noted.

ID number starts with "0000"

*DO NOT USE YOUR PERSONAL EMAIL ADDRESS* Please use your Loyola University issued email address

Please check all that apply

Accommodation History

Have you previously received accommodations in high school or at another university?Required

Please do NOT copy and paste from any documents. The student narrative is important and they should be listing the accommodations. 

Accommodation Request
I am requesting academic accommodationsRequired
I am requesting housing accommodationsRequired
I am requesting temporary assistanceRequired
I am requesting meal plan accommodationsRequired
Upload supporting document(s)

Please note:Student input is a valuable source of information in determining reasonable accommodations. However, students must also submit documentation of their disability in order to register with SAC. Once the appropriate documentation is received, an appointment should be scheduled with a SAC staff member to review and determine reasonable accommodations. If you have questions about documentation guidelines please click here to visit our website.

LUC Release of InformationRequired

I understand that personnel in the Student Accessibility Center (SAC) may need to communicate with faculty, staff, and other personnel at Loyola University Chicago in order to provide accommodations for my disability. I understand that this is for the purpose of coordinating accommodations, and  SAC personnel do not share diagnostic information unless it is on a need to know basis. This authorization is for internal Loyola University Chicago purposes, and it does not include permission to release information to a third party. 

This consent is valid during my entire enrollment at Loyola. I understand that I may revoke this consent at any time by submitting to the Student Accessibility Center a written revocation that is signed by me and witnessed by another person who knows me.

I authorize personnel in the Student Accessibility Center (SAC) to release information about my interactions with the SAC  to outside parties listed here (family, providers, etc.):

Please list specific names (example: Sue Jones instead of "mom"). You may choose to leave this blank. If you do not wish to release information to outside parties (family, providers, etc.), please enter "not applicable" in the text box. 

SAC PoliciesRequired

I am acknowledging that I have read the Student Rights & Responsibility Agreement. By checking below, I am acknowledging my understanding of these procedures and willingness to comply with all SAC policies and procedures. Please click here to read the Student Rights and Responsibility Agreement. 

I am acknowledging that I have read the Grievance Procedure. By checking below, I am acknowledging my understanding of these procedures and willingness to comply with all SAC policies and procedures. Please click here to read the Grievance Procedure.