DRC Forms
Important Forms for New Students
Applying for Services
- Application for DRC Services
- Medical Verification Form
- Learning Disability (LD) Packet
- Upload Disability Documentation - Use this form if you could not upload it on the application or you need to submit updated proof of disability.
Sending/Receiving Private Disability Information
- Permission to Release Documents and/or Information to a Third Party (ex. parent, guardian, another college, etc.)
- Permission to Request and Receive Documents from Another College or University on Your Behalf
- Revoke Authorization to Release Information to a Third Party
- Permission to Disclose DRC Affiliation with Another Cañada College Program (ex: TRIO, Promise, EOPS, etc)
Student Accommodations
Important! Every semester, students must request their accommodation memo using this link:
- Request for Accommodation Memo - Must request every semester you'd like to use accommodations
Test Proctoring Forms
- Students, please complete this form: Request Proctoring Appointments from the DRC
- Professors, please complete this form: Proctor Information Form
Notetaking Requests
Note: Students with notetaking support accommodations may use this form to request a peer notetaker. Also please complete the Assistive Technology form to request access to Otter.ai or a Smartpen.
Alternative Media and/or Assistive Technology
- Alternate Media request form - digital textbooks uploaded to Kurzweil, materials in Braille or large print, and so on
- Assistive Technology request form - software and equipment that supports learning accommodations
- Audio Recording Agreement for Students
Accommodation Forms for Deaf/Hard of Hearing
Other Accommodations
- Remote Learning Robot Request Form
- Permission for Tutoring Group Sessions
- Furniture Request Form
- Personal Care Attendant Agreement for Students
- Personal Care Attendant (PCA) Agreement - This must be completed by a PCA
- Reserved Seating Request
- Service Animal Agreement
For Faculty and Staff
Instructor and Staff Referrals
DRC Student Workers
- For Peer Notetakers:
- For Student Ambassadors, Specialized Tutors, and Mentors:
DRC Counseling Internships
- Both of these forms are required: