Alternate Format Implementation Form Required form students fill out to receive alternate format services after being approved. Copy link "*" indicates required fields I am... * Required Student who has been approved for alternate format textbooks and course readings Disability Services Specialist (DSS) who approved a student for alternate format textbooks and course readings Who is the student's Disability Services Specialist? * Required Erin Broskowski (College of Medicine) Michelle Coles (Deaf/HOH Students, College of Business Administration Students) Kelly Gerhardt (LAS Students with Last Names D-Mn) Sophia Hamilton (Law School students) Gail Makuch (LAS Students with Last Names Mo-Z) Jackie Padilla (Students in CADA; LAS Students with Last Names A-C) Melanie Salas (Students in College of Engineering and CUPPA) Hugo Trevino (Students in Applied Health Sciences, Social Work, Nursing, Dentistry, Public Health, Pharmacy) Student Name * Required First Last UIN * RequiredExample: 650712609UIC Student Email Address * RequiredExample: nsims3@uic.eduWhat format did your DSS approve you for as outlined on your Letter of Accommodation? * Required Searchable PDF Screen reader accessible word documents Word documents with a specific font and/or size Please specify any specifications you're requesting (font, font size, alt text, headings etc.)What devices does the student primarily use to complete course work? * Required PC (Windows) Laptop Mac (OS) Laptop Android Tablet iPad Android Phone iPhone What barriers does the student encounter when working to complete course work and/or digital tasks? * RequiredWhat apps or programs if any, is the student currently using to help mitigate these barriers? If no, put "N/A." * RequiredWould the student like additional alternate format resources? * Required Yes No Which method would the student like to receive additional alternate format resources? * Required Email Brief Zoom meeting Both Comments Δ