Request for reasonable adjustments for doctoral students with disabilities

Last name ^*

First name ^*

Student number ^*

E-Mail ^*

Academic level: Doctorate

Situation ^*

The application for reasonable adjustments is valid for ^*

a specific exam a specific semester all doctoral studies

Which specific exam? ^*

Which semester? ^*

The application for reasonable adjustments relates to ^*

Written examinations Oral examinations Other performance assessments

What other performance assessments? ^*

Type and scope of measures ^*

Is this your first request for reasonable adjustments at ETH? ^*

Yes No

Have you ever been granted reasonable adjustments at another educational institution due to disability? ^*

Yes No

If yes, in which form?

The following supporting documents are enclosed with this request:

Medical certificate Confirmation of reasonable adjustments at previous educational institutions Further documents

Please upload documents in PDF format?^*

By sending the request you acknowledge that your documents in support of the request for reasonable adjustments may be passed to the responsible internal offices, insofar as this is required for decision-making and implementation of measures.

I would like to receive a copy of the form content by email.

Request for reasonable adjustments for doctoral students with disabilities

Thank you. Your request has been submitted