Public Accommodation Request

Student Information

Please enter your information

First Name

Last Name

Middle Name

Student ID

This must be your Tufts numerical student ID.

Pronouns

Tufts Email

Please use your university issued email address.

Cell Phone Number

Where do you live?

Are you a Tufts student athlete?

Are you a protected veteran?

Academic Information

Is this your first semester at Tufts?

Are you a transfer student?

What school are you enrolled in (or soon to be enrolled in)?

Note: StAAR only works with students enrolled in the schools of Arts & Sciences, Engineering, SMFA, and Fletcher. The StAAR Center does not work with medical, dental, vet, or Friedman School students.

Are you a full-time or part-time student?

Are you participating in a summer program?

What is your current or anticipated program of study (major, minor, degree program, etc.)?

What is your anticipated year of graduation?

Disability Information

Notice of Confidentiality

Please be aware that as university officials, Student Accessibility and Academic Resource (StAAR) Center staff are mandated reporters.

If a student's accessibility request or documentation discloses experiences related to sexual misconduct, relationship violence, and/or harassment, StAAR staff are required to connect that student to support resources within the Tufts Office of Equal Opportunity. Next steps after this referral are completely in the hands of the student.

For confidential support, students may connect with CARE through email (care@tufts.edu), phone (617-627-3752), or their website (care.tufts.edu).

In addition, any disclosure of a student being in immediate danger to themselves or others will be escalated to appropriate emergency channels.

Please contact the StAAR Center at 617-627-4539 or StAARCenter@tufts.edu if you have any questions about this policy.

Please describe your disability or disabilities.

Disabilities we work with include:

Hearing, vision, speech, or mobility impairments
Learning disabilities
Serious medical or mental health conditions
Temporary conditions such as injuries or broken bones

Is your disability

When was your disability initially diagnosed?

If your disability is temporary, how long is it expected to impact you?

Have you given StAAR your clinical documentation?

Students need to provide clinical documentation to accompany their request. For more information, visit our website.

Please upload supporting documentation.

Students need to provide clinical documentation to accompany their request. For more information, visit our website.

List any current treatments you engage in for your disability, if applicable.

For example: medication, physical therapy, assistive devices or technology, surgery, counseling, etc.

Accommodation Information

Please describe what accommodations you are interested in seeking.

Please include information about both academic AND non-academic (housing, transportation, dining) accommodations on the same form, if applicable.

In your own words, please describe the nature of your condition and how it may impact your Tufts experience.

Appointment/Follow-Up Information

How did you hear about us?

What other resources would you like us to help connect you to?

Confidentiality and Disclosure of Information

Please read the following:

1. All information maintained by the StAAR Center is part of a student’s educational record and as such protected by the Federal Family Educational Rights & Privacy Act (FERPA).

2. Students wishing to waive their FERPA rights and allow information in their educational record to be shared with someone other than themselves must fill out and sign a FERPA release.

3. Documentation pertaining to a student’s diagnosis (including, but not limited to, diagnostic evaluations, IEPs/504 plans, medical records, etc.) should only be submitted to the StAAR Center.

4. The StAAR Center office strongly advises students to keep a copy of their documentation.

5. Registration with the StAAR Center and/or the use of accommodations does not appear on student’s transcripts from the university.

6. Disclosure to the StAAR Center does not constitute disclosure to other offices, services, or professionals at Tufts University.

7. In order to use academic accommodations in a course, a student must disclose their accommodations approved by the StAAR Center to the Faculty member of record for that course.

8. Information is only shared with other professionals at Tufts University to facilitate the provision of accommodations when necessary and/or if questions arise.

9. Information pertaining to a student’s diagnosis will not be shared with other professionals at Tufts University without written consent from the student.

10. Students requesting release of information must fill out and sign a consent form.

11. When a student has graduated or is no longer a student at Tufts University, the student’s file is archived.

Please reach out to the StAAR Center at 617-627-4539 or StAARCenter@tufts.edu with any questions or concerns.