Disability Support Registration Form

Thank you for choosing to register with Disability Support. Please complete all relevant sections of the registration form below.

We understand it may take you time to obtain or get copies of relevant supporting medical documentation. We encourage you to register with our service as soon as you enrol in your courses.

If you need assistance to complete this online registration form, please phone Disability Support onÌý08 8313 5962.

Personal details

Please indicate if you are a current or prospective student

(Date format: DD/MM/YYYY)

Are you:

Country of citizenship

Contact information

NB: This will be the main communication channel.

Please specify your automatic appointment reminder preference
For pre-booked appointments, an automatic appointment reminder is sent 24 hours prior to the appointment.

Program information

Enrolment status

Disability/medical information

Please be assured that the information you provide on this form is only available to Disability Support.
Did you have special provisions in Year 12?
Please upload any documentation of Year 12 provisions.
One file only.
20 MB limit.
Allowed types: gif, jpg, jpeg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, mp4, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.
Have you previously studied at a tertiary institution?

Please upload documentation of any special provisions or Access Plan.
Unlimited number of files can be uploaded to this field.
20 MB limit.
Allowed types: gif, jpg, jpeg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, mp4, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.

I would like to discuss:
Please note multiple options can be selected.

Medical information & documentation

Please add your supporting documentation.


Unlimited number of files can be uploaded to this field.
20 MB limit.
Allowed types: gif, jpg, jpeg, png, odf, pdf, doc, docx.

Unlimited number of files can be uploaded to this field.
20 MB limit.
Allowed types: gif, jpg, jpeg, png, odf, pdf, doc, docx.

If you are unable to provide your relevant documents, please outline the reason below:
Additional information

Disability Support acknowledgement and consent

By registering with Disability Support, I understand that:

  • Details of my medical condition provided in my online registration, and supporting medical documentation will be stored confidentially and only be available to staff within Disability Support, and
  • Only the impact of my condition on my studies (not my diagnosis) will be included in my Access Plan and/or Alternative Exam Arrangements.

Personal information held in my Student Record

I consent to Disability Support staff checking the information provided when I register for Disability Support against the information provided when I enrolled at the University, and making any amendments to my Student Record that may be required to ensure that my Personal Information, related to disability, is accurate, up-to-date and complete.

Provision of de-identified data to Department of Education Skills and Employment (DESE)

For service funding purposes, The ³ÉÈË´óƬ is required to provide de-identified data to DESE. This data is collated from information provided during enrolment and relates to the following:

  • The number of enrolled students with disabilities, and
  • The broad categories of disabilities (e.g. medical, physical, vision, mental health).

By giving Disability Support your consent to update your enrolment information as necessary, we can ensure that the de-identified data provided to DESE is as accurate as possible.

I understand that I can update my Personal Information with the ³ÉÈË´óƬ at any time in accordance with the University’s Privacy Policy and Student Privacy Statement.

Acknowledgement and consent