Disability Resource Center Information Request Form
Disability Resource Center Information Request Form
First Name
*
Last Name
*
Panther ID
*
Must be
7
characters.
Currently Entered:
0
characters.
Email Address
*
Phone
Phone
-
###
-
###
####
FIU Student Status
*
FIU Student Status
Registered
Unregistered
Current Academic Level:
*
Current Academic Level:
Freshman
Sophomore
Junior/Transfer with AA
Senior
Graduate/Doctoral
Non-degree
College of Medicine/College of Law
Preferred Campus:
Preferred Campus:
Modesto Madique Campus (MMC)
Biscayne Bay Campus (BBC)
Request Information on:
Request Information on:
Accommodations
Services offered
Testing
Appointments
Other
Other
Please allow 3 to 5 business days for your request to be processed