Disability Documentation Request Form

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Documentation Request Form

Spartanburg Community College provides reasonable accommodations to qualified individuals who have, have a history of, or are regarded as having a disability. Spartanburg Community College may ask you to provide appropriate documentation to support your request. All accommodations at Spartanburg Community College are authorized by the office of Student Disability Services, as no other office on campus is authorized to establish accommodations. If you have questions please call SDS at 864-592-4818 or email SDS at disabilityservices@sccsc.edu.

Student Disability Services will only discuss your academic accommodations with faculty and staff of Spartanburg Community College who have a legitimate academic interest, as defined by the Family Educational Privacy Rights Act (FERPA). Medical documentation will be kept strictly confidential and will only be viewed by employees of Student Disability Services, administrators of Spartanburg Community College, and regulatory agencies in the course of legitimate inquiries. Spartanburg Community College does not collect genetic information about students.

First Name:

Last Name:

Date of Birth:

SCC ID:

Personal Email:

SCC Email:

Primary Phone:

Secondary Phone:

Enter the last four digits of your Social Security Number to verify your identity:

e.g. 9999999999

I hereby certify that I am requesting a copy of my official documentation which I provided to the office of Student Disability Services at the time I registered. I understand that I am under no obligation to share my documentation with any office other than the office of SDS. I understand that according to the Americans with Disabilities Act, appropriate documentation may include a letter from a qualified professional or evidence of a prior diagnosis, accommodation, or classification, such as eligibility for a special education program.

Reason for request:

Delivery Method:

Documentation requests received will be responded to in two business days. If you have questions please contact the office of SDS.

Giles Campus (Main Campus)

P. Dan Hull Building

Office 4

disabilityservices@sccsc.edu

864.592.4818

Electronic Signature:

Date:

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