Disability Declaration and Request for Accommodation

All students with disabilities requesting services or accommodations from the office must complete the Disability Declaration and Request for Accommodations Form upon their first contact with the office. 

Complete and submit this form once, with first contact with the office. The form is available in both Word and PDF format.

Note: PDF files can be opened and read with Adobe Acrobat Reader. If Acrobat Reader is not installed on your computer, you can download it for free from Adobe. (This link opens in a separate window.)

If you are unable to access the forms on this page and would like to request a printed copy, please contact the Office of Accessibility Resources and Services

Contact us

If you have any questions related to disability services, you can find additional information on the community resources and frequently asked questions pages, or you may contact the accessibility resources staff at:

Andrea Piazza, Disability Specialist
Office of Accessibility Resources and Services
Phone: 800-847-3000, ext. 2244
Fax: 518-584-3098
NYS Relay Service 800-421-1220
Disability.Services@esc.edu

Melissa Zgliczynski, Director
Office of Accessibility Resources and Services
Phone: 800-847-3000, ext. 2244
Fax: 518-584-3098
NYS Relay Service 800-421-1220
Disability.Services@esc.edu