UCLA School of Nursing Acknowledgement Form

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Please be sure to read the Technical Standards for Students before completing this form.
Link to Technical Standards for Students:
https://drive.google.com/file/d/15SYU3xBI5OT44lm9FdHsnujBShPG5890/view?usp=sharing

I have reviewed and understand the Technical Standards for Students for School of Nursing students as vital for safe patient care. I am able to perform these Technical Standards with or without accommodation. Please initial. *

I understand it is my responsibility to contact the Center for Accessible Education (CAE) at UCLA to initiate the process of reasonable accommodations for the program. Any request for accommodations must be initiated sufficiently in advance of courses with the CAE. Please initial. *

Due to the complexity of nursing clinical placements, requests should be made at least six (6) months before clinicals or labs begin. Should I delay my request, this may negatively affect ability of the nursing program to accommodate me for clinical placements and could delay my progress in the program. Please initial. *

If reasonable accommodations are approved, I understand that the CAE will communicate in advance with nursing faculty responsible for clinical courses in order to best discuss reasonable accommodations needed to succeed in the clinical aspects of nursing courses. Please initial. *

I understand that if an approved accommodation is believed to fundamentally alter essential Tehchncal Standards, the CAE and the School of Nursing will engage in a Determining Essential Requirements and Fundamental Alterations. Please initial. *

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