Disability/Medical Condition Request For Assistance Form

* indicates a required field

Student Information

Please enter your information
Please use your email address issued by the University of Notre Dame Australia

Admissions and Academic Information

Are you a prospective student or enquiring on behalf of a prospective student?
{"display_name":"What campus are you attending?","hidden_field_name":"ms_field_1","init_id":"ms_field_1","init_link":"","has_autocomplete":false,"has_hierpicklist":null}

Accessibility Specific Information

Upload supporting document(s)

If you do not have any current supporting documentation, please select your campus to download a copy of our Treating Health Professional Report. Please complete and bring this to your first appointment. 

Treating Health Professional Report (Fremantle)

Treating Health Professional Report (Sydney)

Preferred method of contact
Please indicate which day/s you prefer appointments to be scheduled
We will do our best to accommodate your preferred appointment days, but it may not always be possible.

Please specify morning or afternoon and/or specific times for your appointment.

I understand that it is my responsibility to distribute my Learning Access Plan (LAP) to relevant Notre Dame staff, and to do so in a timely manner to ensure adjustments are implemented. 

Privacy Statement

The information provided in this form will be used for the purposes of, and in relation to, your potential enrolment at The University of Notre Dame Australia. Where the privacy principles apply, the University restricts access to those staff members who may need the information in the carrying out of their responsibilities in the academic and/or personal interests of the student. The University does not provide, by commercial arrangement or otherwise, the personal information of students or other stakeholders except in the following cases: a) when authorised in writing to do so, and b) where required or authorised by law to government and regulatory authorities; credit reporting and fraud-checking agencies; to your authorised representatives (e.g. legal representatives).