Carlow University Disclosure Notice
Services for Students with Disabilities

If you are an admitted student with a disability and will be requesting some accommodations, adjustments, or services with regard to:

classroom or academic support
mobility and accessibility
campus housing
health or counseling
access to disabilities services

you will need to notify the University at least one month prior to your starting date (for Residential Life, allow 6 to 8 weeks) in order to ensure a reasonable amount of time for reviewing documentation and arranging for the appropriate accommodations or services.

To do this:

  1. complete the following information
  2. attach current, formal medical or professional documentation, provided on the professional's letterhead and signed, which describes the disability, the way in which you are impacted by the disability, medications (if applicable), and services requested (Refer to guidelines for documentation.
  3. mail this form and the documentation to

Joan House
Director of Disabilities Services
Carlow University
3333 Fifth Avenue
Pittsburgh, PA  15213

The Disabilities Services Provider may direct this information to or coordinate a response with one of the following offices:
For Health Related Issues: Julie Gaul, Director of Wellness and Fitness
For Mental Health and Counseling: Nellene Groetsch, Director of Counseling
For Mobility: Carl Stivenson, Director of Security
For Residential Life and Housing: Mary Beth Halferty, Director of Residence Life

Please Provide All of the Following Information:

Nature of Disability  
Name  
Date  

 

Social Security Number  
Address
  
Phone Numbers:  

Home

  

Work

  
Major  
Program  

Traditional Day

  

Carlow Hill College

  

Adult Day

  

Graduate

  

WEC/CAP

  

Other

  
Name of Physician or Professional Providing Documentation  

List any further details which you feel will be helpful:

 

Signature  

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