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Office for Students with Disabilities

Forms

Office for Students with Disabilities at CSULA have created a variety of forms for your use. Some of these pages may contain pdf files. They are in this format to protect the document integrity. The documents in Microsoft Word format allows one to type in information -- this includes two service request forms. After completing the form, you may deliver them to the OSD in Student Affairs room 115. Call 323-343-3140 if you have any questions.  

Request for Services Form:    Student fills out to request specific services.

Request for Custom Services Form:    Student fills out to request specific services related to Deaf and Hard of Hearing issues.

Alternative Media Request Form:    Student fills out to request alternative media.

Time Sheet for Service Provider:    Staff providing services for students who are deaf or hard of hearing fills out to request specific services related to Deaf and Hard of Hearing issues.

Feedback Form:  This form is design to give students an opportunity to report back to the Office for Students with Disabilities about the quality of services.

Student's Permission to Release Medical Information Form:  This form is designed to let students obtain medical information from their doctors and psychologists.

Authorization to Release Student Information Form:  This form is design to give the OSD permission by students to release information about them.

Vendor Data Record & Direct Pay Request are two forms used by notetakers. Notetakers:  Please download these forms, print and complete the fields highlighted.  Please submit completed forms to Notetaking Services at OSD.”

Time Sheet for Student Workers:    This is a time sheet for OSD student workers to record their hours worked each month and then printed and submitted by the 15th of each month.

5151 State University Drive . Los Angeles . CA 90032 . (323) 343-3000
2008 Trustees of the California State University

Last Update: 07/11/2012