OCOM Disability and Accessibility Release of Information Form

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Release of information for the use of the OCOM Office of Student Services. Registered students with the Office of Student Services provide sensitive and confidential information. The Office of Student Services aims to protect student's confidential information and disseminate appropriate information to appropriate individuals within OCOM. Any questions or concerns can be sent to disabilityservices@ocom.org

Student Name (First and Last) *

Student Email Address *

Student Phone Number *

Academic Year:
*

OMS-I

OMS-II

OMS III

OMS IV

I understand and give permission for the Office of Student Services to provide appropriate information to designated individuals within OCOM regarding disability and access accommodations.
*

Yes

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