Voluntary Student Accommodation Assessment Intake


Stella and Charles Guttman Community, CUNY, we are committed to the full participation of all students in our programs and activities. Guttman COmmunity College is mandated by Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act of 1990 to provide equal access to facilities, educational and co-curricular programs, campus activities and employment opportunities to qualified individuals with disabilities.

The Office of AccessABILITY Services would like to welcome you to our office and services. Our goal is to provide reasonable accommodations and a supportive, well-resourced environment to students with disabilities in order to promote student success in the university environment.

Guttman Empl ID:
Phone #:
Guttman E-mail:
Personal Email:
Name of High School or College previously attended:
What is the nature of your impairment? (check all items that apply to you):

Students diagnosed with a disability that request services or accommodations are required to provide appropriate and current documentation in order to be considered for accommodations.
Are you taking medication due to your disability?
Approved Academic Adjustments: Note: Each accommodation requested must be supported by appropriate documentation. You will be advised of approved recommendations based upon your submitted application.

In case of emergency, who can we contact on your behalf?
Exchange of Information In order to best meet your individual needs and reasonable accommodations, may we have your permission to discuss any documentation that you submit with:
Your physicians/psychologist or qualified professional
Sponsoring Agency (Acess-VR, Commission for the Blind, VA)
Selected Guttman Community College Professional Faculty & Staff
I understand that this application is a request for services. Determination of eligibility for requested accommodations will be based upon review of supporting documentation.