Disability Unit Walk-In Form
The Disability Unit walk-in service is a session with a DU team-member to help us find out how we can best assist you.
YOU ARE REQUIRED TO COMPLETE THIS FORM FOR EACH CONSULTATION WITH THE DISABILITY UNIT. REMEMBER: If applying for any reasonable accommodations (including extra time), you MUST get a renewal letter from the Disability Unit every year!
The information disclosed in this form may be shared with the UP Disability & Reasonable Accommodation panel members and other UP stakeholders on a “need to know” basis. It must be noted that support cannot be provided retrospectively (particularly in cases relating to appeals and academic exclusion).
UP will take all reasonable measures to protect the confidentiality of the information and to comply with any data protection laws that may be applicable. I give consent that the information may be stored, processed, transferred, released and/or communicated in any format for the purposes stated herein. I also consent to the information being used for statistical data purposes at the UP.
I am aware that if I do not agree to the sharing of information with relevant University staff or other relevant professionals or disclosure by my treating health professional/specialist, that this may limit the level and type of support UP can provide to me. I confirm that I understand fully the consequences of the above and that I was not coerced in any manner to sign this document.
It must be noted that following your consultation with the Disability Unit it it takes a MINIMUM of FOUR WEEKS for the entire concession application process to be finalised. Furthermore, whilst concessions are considered they are not automatically granted. A previous award of extra time by another institution does not guarantee that the same concession will be approved whilst the student is at UP. A diagnosis in and of itself does not automatically warrant approval of requested concessions. Concessions cannot be applied for restrospectively, thus concessions are only considered for from the date of approval onwards. Concession support is not intended to alter the entrance requirements and fundamental elements of the curriculum or program of study. Furthermore, the Disability Unit does not process Academic Exclusions/Dismissals/Appeals). All students are required to meet the academic standard as per faculty regulations.
Whilst health professionals may submit recommendations regarding accommodations, the University who is familiar with the educational environment at UP determine the extent to which the recommended accommodations are appropriate in this context. Thus, the recommendations by the health professionals are helpful but not binding. Should there be insufficient diagnostic or clinical information in support of the requested accommodations; students may be asked to submit new and/or additional documentation. It should be noted that whilst applications are considered, they are not automatically granted.
Name and Surname
Student Number or ID/ Passport Number
Economic and Management Sciences
Engineering, Built Environment and IT
Natural and Agricultural Sciences
Gordon Institute of Business Science
Year of Study (Academic Year - not historic)
Post Graduate Certificate/Diploma
Parent of Student
Nature of Disability
Blind (no functional vision)
Deaf (capital D and generally makes use of SASL and typically subscribes to Deaf Culture)
Hearing Impaired/Hard of Hearing/deaf
Psychological Disability (e.g ADHD, Dyslexia, Schizophrenia)
Medical Disability (A long standing medical condition /illness that affects daily functioning)
Neurological (e.g. Epilepsy, Traumatic Brain Injury)
No Disability/Only here to consult (e.g. group project, private company.)
Course (name of degree)
Student Counselling and Support
Health professional (E.g your psychologist, neurologist, psychiatrist)
Brief Summary of the reason you are consulting with the Disability Unit or why you were referred.
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This form was created inside of University of Pretoria.