Disability Support Services Forms

Request for Sign Language Interpreting Services 

For students enrolled in a Canisius College program, or those attending orientations

Exam Proctor Form and Checklist

Exam proctor form for students either registered with DSS or make-up exams.

Permanent Intake

For students with permanent disabilities

Request for Note takers 

DSS registered students, who qualify to receive a note taker as an accommodation must fill this out for each class, each semester they need a note taker

Request for Alternate Text

DSS registered students, who qualify to receive  books in alternative format as an accommodation must fill this out for each class, each semester of need

Permission to Release Information

This form allows DSS to release information for a variety of reasons

Special Need Housing Accommodations

DSS registered students, who are in need of housing accommodations must fill this out each academic year of need

Statement of Academic Integrity

DSS is dedicated to academic excellence and is, therefore committed to establishing and maintaining an atmosphere of trust. All students registered with our office must sign this statement.

Temporary Intake

For students with a temporary disability such as a broken bone, surgery, accident, etc.)

Testing Accommodation Request

Requests should be submitted one week in advance. If you have any questions on the testing accommodations, please contact Anne-Marie Dobies, at dobies@canisius.edu or (716) 888-3748.

Updated Information Request

DSS registered students, must update their contact information each academic year

Voluntary Disclosure

For students seeking DSS registration, who have been documented with another professional, office or organization

Inquiry Form

Fill out this form to have someone from the DSS Office contact you regarding registering with the office

Evacuation Plan