Disability Accommodations Intake Form
This form must be filled out by all students requesting accommodations at Thomas Jefferson University. The form can be submitted digitally through Accommodate or by mail:
Office of Academics & Career Success
130 South Ninth Street
Edison Building, Suite 1800
Philadelphia, PA 19107
Medical Intake Form
If you do not currently have documentation, or your documentation does not meet the documentation standards, utilize the form above. You will need to fill out Section I of the form and then pass along to the appropriate medical professional.
Proctor Request Form
Faculty, please complete the following form to request a proctor for an upcoming student exam. The Office of Student Affairs will do everything to honor this request; however, we cannot guarantee a proctor will be available for the requested time. Please submit your request seven (7) days in advance of the exam. For requests made in less than seven days, submit the form and contact James.Dyksen@jefferson.edu as soon as possible.
ESA Medical Intake Form
If you are requesting an emotional support animal (ESA), an appropriate medical professional will need to fill out the form above.