Initial Information Form

* indicates a required field
Completing the Initial Contact Form is the first step in connecting with the SSD office

This form is to be used by current, committed, and prospective students for the University of Michigan Ann Arbor interested in or requesting disability academic accommodations, academic adjustments for temporary injuries/conditions and/or Paratransit Services for the University of Michigan (Ann Arbor) Campus Transit System.

Learn more about the process of getting connected with SSD

If you experience any difficulty in filling out this form, please contact the SSD front desk at 734-763-3000 or email us at ssdoffice@umich.edu.

All information supplied through this form is protected under FERPA and managed by SSD separately from other university record systems.

Personal Information

This should reflect your name on record with the university or your legal name.

For Students, please complete if different from name on record with the university. You can change the name on record with the university by following the steps on the Spectrum Center webpage.

For example: they/them or he/him; she/her; ze/zir; they/he; or any pronouns
If none exists, please leave blank
Please use your university issued email address. If you do not have a University of Michigan email, please put an email where you can be reached.
This is for verification purposes, all office communication will go to UM email.
Date of Birth:Required
MM/DD/YYYY

Academic Information

This section is for current, prospective, or admitted/committed students.
Please Indicate if you are currently undecided
Have you previously worked with a SSD coordinator?

Temporary Conditions/Injuries

This section is for current or committed students who are impacted by a temporary condition/injury. 

Temporary conditions/injuries refer to a short time period in which a person is impacted by a short term condition/injury/trauma, such as a broken limb, concussion, or a surgical procedure.

Disability Accommodation Information

This section is for Students ( current, prospective, or admitted/committed) with a disability (medical, physical, mental, sensory condition), suspect they may have a disability, or are seeking accommodations because of a diagnosis. 

Students with questions about disability accommodations or who are seeking disability accommodations for academics at the University of Michigan -Ann Arbor Campus should complete the information below. 

This information is necessary for staff to be able to support you. 

Paratransit

This section is for current, committed, and prospective students who are unable to ride the UofM Transit System. 

Transportation Services offers curb to curb Paratransit services for students, faculty and staff (clients) that are pre-qualified through the Office of Services for Students with Disabilities (SSD) (Students) or ECRT Disability Equity Team (Staff, Faculty, community members). 

This is a year-round service that operates on weekdays only.  Rides are provided within a .75 mile radius of the Ann Arbor campuses as well as The East Ann Arbor Health Centers and Domino's Farms satellite facilities.

Documentation/Closing

If you selected 'No' to paratransit, Temporary, AND Disability, please indicate why you are reaching out to the office. 

Upload supporting document(s)

Please be sure to upload documentation and clearly label it prior to upload. 

Upon Submission

All information supplied is kept confidential and submitted directly to the SSD office. 

You will be contacted via email by the SSD Office.

For individuals affiliated with the university, communication will be sent directly to the University of Michigan email address.

If you have not heard from us after 3 business days, please contact our office at 734-763-3000