DRC Forms
Important Forms for New Students
Applying for Services
- Application for DRC Services
- Medical Verification Form
- Learning Disability (LD) Packet (in English)
- Learning Disability (LD) Packet (en Español)
- Upload Disability Documentation - Use this form if you could not upload it on the application or you need to submit updated proof of disability.
Sending/Receiving Private Disability Information
- Permission to Release Documents and/or Information to a Third Party (ex. parent, guardian, another college, etc.)
- Permission to Request and Receive Documents from Another College or University on Your Behalf
- Revoke Authorization to Release Information to a Third Party
- Permission to Disclose DRC Affiliation with Another Cañada College Program (ex: TRIO, Promise, EOPS, etc)
Student Accommodations
Important! Every semester, students must request their accommodation memo by submitting this form:
Test Proctoring
- Students, please complete this form: Request Proctoring Appointments from the DRC
- Instructors, if the student will complete their exam at the DRC, please complete this form: DRC Proctor Information Form
- Instructors, if the student will complete their exam at the Learning Center, please complete this form: Cañada College Learning Center Test Proctoring Instructions
Peer Note Taker
Note: Students with note taking support accommodations may use this form to request a peer note taker. Also please complete the Assistive Technology form to request access to Otter.ai, Glean, or a smart-pen.
Alternative Media and/or Assistive Technology
- Book Request for Alternate Media - digital textbooks uploaded to Kurzweil, materials in Braille or large print, etc.
- Audio Recording Agreement for Students
- Assistive Technology request form - software and equipment that supports learning accommodations
Deaf/Hard of Hearing Accommodations
Other Accommodations
- Tutoring Agreement
- Remote Learning Robot Request Form
- Furniture Request Form
- Personal Care Attendant Agreement for Students
- Personal Care Attendant (PCA) Agreement - This must be completed by a PCA
- Reserved Seating Request
- Service Animal Agreement
For Faculty and Staff
Instructor and Staff Referrals
DRC Student Workers
- For Peer Note takers:
- For Student Ambassadors, Specialized Tutors, and Mentors:
DRC Counseling Internships
- Both of these forms are required: