Accessibility Needs in Residence

Student Housing & Residence Life is committed to meeting the accessibility and accommodation needs of students. To determine how best to accommodate you while living in residence, we encourage students to share specific information relating to your disability related needs. Disability related needs can be reported through the form below.

Disclosing any medical information is voluntary, and will only be used for emergency response and for developing your support plan in partnership with Student Housing & Residence Life while living in residence. The information you provide is kept confidential.

Should you have any questions about completing this form, please contact AccessAbility Services at Tel/TTY 416-287-7560 or ability@utsc.utoronto.ca.

First Name *

Last Name *

Student Number *

Email Address *

Preferred Phone Number *

Please indicate the nature of the disability related restrictions or limitations for which accommodation is required (check all that apply)

Mobility

Does your disability or health condition impact your ability to use the stairs?

Yes

No

Do you require an automatic door opener?

Yes

No

Do you use mobility aids?

Yes

No

Visual

Do you use braille?

Yes

No

Hearing

Medical

Allergy

Please describe the nature and severity of the allergy (e.g. mild, moderate, severe, anaphylactic).

Other (please describe)

Other - details

If the disability/health condition is temporary, please indicate the anticipated date of recovery (if known):

Does your reach / range of motion require adjustable or adapted housing components (e.g. lowered shelving, accessible kitchen, etc)?

Yes

No

Does your manual dexterity require adjustable or adapted housing components (e.g. lever handles, “D-pulls” instead of knobs, etc)?

Yes

No

Does your disability / health condition impact your washroom use frequency?

Yes

No

You are responsible for bringing your own assistive devices and/or medical equipment. What disability related equipment will you be bringing with you? (check all that apply)

Assistive Devices - Other Details

Do you require any of the following for disability related reasons: (check all that apply)

Will you be using the assistance of a Personal Care Attendant?

Yes

No

Please note that the university does not arrange for provision of personal care attendant services. Students are encouraged to contact the Centre for Independent Living Toronto (www.cilt.ca) for information and resources about Attendant Care.

Do you require the use of a service animal?

Yes

No

Please indicate type of animal

Please note that students are required to submit supporting documentation, by a regulated health care practitioner, verifying their need of a service animal for reasons of a disability. Documentation must specify type of animal. Please contact AccessAbility Services directly to receive further instruction on submitting the required documentation.

Do you need assistance during an emergency evacuation?

Yes

No

If yes, please list the specific assistance you will require.*

Emergency Evacuation - Consent

Do you have a Ministry of Transportation Accessible Parking Permit?

Yes

No

If yes, will you be bringing your own vehicle?

Yes

No

Is there any additional information relating to your disability/health condition that will impact your housing needs?

Confidentiality and Consents

The University of Toronto respects your privacy. Personal information that you provide to the University is collected pursuant to section 2(14) of the University of Toronto Act, 1971. AccessAbility Services is responsible for assessing disability related accommodation needs on behalf of University of Toronto, Scarborough. Pursuant to this goal, your personal information is being collected because it is necessary for the purposes of establishing, reviewing, and/or supporting appropriate accommodations and services at the University.
At all times it will be protected in accordance with the Freedom of Information and Protection of Privacy Act. If you have questions, please refer to www.utoronto.ca/privacy or contact UT Scarborough's Freedom of Information Liason (FOIL), Brent Duguid, at (416) 287-7033 or brent.duguid@utoronto.ca, Office of Business, Operations and Strategic Affairs, 1265 Military Trail, AA415B, Toronto, ON, M5A1A4.

I give consent for Student Housing and Residence Life and AccessAbility Services at UTSC to consult on the information provided herein, in order to identify housing solutions that will meet my disability related needs.

Please note that a member of the Student Housing and Residence Life team and/or AccessAbility Services may contact you if clarification or additional documentation is required.

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