Student Request for Services Form

Please fill out the Student Request for Services Form and upload supporting documentation. Contact or 617-879-5995 with any questions.
* indicates a required field

Student Information

Please enter your information

Include the numbers only. Do not include the "m"

If you are an incoming student and have not been issued an MCPHS ID number you may write "none"

Please use your university issued email address. If you are an incoming student and have not yet been issues an MCPHS email, you may use a personal email. Please refrain from using school emails from other schools unless you have indefinite access. For example, some high schools remove email access after graduation.

Please be sure to double check that your email is entered correctly!

Please share the name of university of employee or student who referred you or provide more context if you chose other

Specific Accommodation Information

This could include the classroom, lab, or other university settings.

Are you an SPS Student?Required

SPS students are students enrolled in a self-paced course with the School of Professional Studies and are not matriculated into a program at MCPHS.

Upload supporting document(s)Required

Documentation should:

  • include a formal diagnosis
  • outline functional limitations (how the diagnosis impacts you)
  • provide recommendations from your provider regarding accommodations
  • be specific to the types of accommodations being requested

Examples may include IEP, 504, psychological testing, doctor's letter etc.

Please note: screenshots of a student's health portal or a medication prescription rarely provide adequate information for OSAA to determine eligibility.

If you have questions about supporting documentation please email or call 617-879-5995.