Intake and Documentation Forms

Directions for Requesting a Housing Accommodation

Residential Life offers a variety of living environments that accommodate many different lifestyle needs. Within this assortment of provisions, there are a limited number of medical single rooms available for students with severe medical, psychological, psychiatric, mobility or visual or hearing impairment related conditions, whereby the symptoms of such conditions prohibit the student from living with a roommate.

Students who feel that they may have such a condition may request as single room accommodation by contacting Peggy Perno, Director of Student Accessibility and Accommodation pperno@pugetsound.edu . You will need to have your treating professional complete a Documentation of Disability Form for Medical Single form, and submit that form along with the Student Intake Form.

Documentation must include all of the following:

  1. Diagnosis

  2. Severity of symptoms

  3. Length of time you have been symptomatic

  4. How your symptoms prevent you from living with a roommate

  5. Medications

  6. A specific statement from your clinician that a single room placement is essential for your attendance at Puget Sound

If you are eligible, a recommendation will be made to the Director of Residence Life.

Some students for reasons related to their disability may need an accessible room or some other type of housing accommodation. To request a housing adjustment, contact Peggy Perno pperno@pugetsound.edu . You will need to have your treating professional complete a Documentation form and submit that along with the Student Intake Form.

Information about the diagnosis and treatment of your condition remains confidential. It is entirely your choice to share or not share this information.