Accessibility Services Intake Form

* indicates a required field

Student Information

This form asks about your experiences as a person with a disability, and how they affect your learning experience. It helps NorQuest Accessibility Services set up your accommodation plan.

This form must be completed before you meet with us.

If you need assistance completing this form, please call us at (587)596-1572.

Please read and agree to the Notice of Collection and Informed Consent linked belowRequired

Notice of Collection and Informed Consent for Accessibility Services

7 digits
Please use your NorQuest issued email address

Accessibility Specific Information

Do you have any diagnoses that would be considered permanent, persistent or prolonged? Required
If you are unsure, please select no, and continue with meeting with an Accessibility Advisor
Have you had accommodations in the past?Required
Do you find it difficult to read words on paper or on a computer screen?Required
Do you find it difficult to write with a pen, pencil or keyboard?Required
Will you take a math course while at the college?Required
Do you experience severe anxiety during tests that leads to:Required
Select all that apply
What technology devices do you own?
Select all that apply
Upload medical documentation and/or educational assessments