The Non-Health Accommodation request form

The Non-Health Accommodation request form for Residences
(Queen’s email is preferable if you have not received it at the time of submission, please provide an alternate)
  • The need for a long bed (must be 195 cms or taller.) Please provide proof through a copy of your driver’s license. A letter from your Health Care Provider certifying your height will be accepted if you do not have a driver’s license or if the height on your driver’s license is no longer
    accurate.
  • Culture/Religion (please explain the specific supports you are requesting in the box provided below). Note: If you are requesting a female-identified (any individual who identifies as a woman) or male-identified (any individual who identifies as a man) community, please request this on the residence application. No further information is required unless you are seeking additional supports.
  • Gender Identity/Expression and/or Sexual Orientation (please explain the specific supports you are requesting in the box provided below)
If you are applying for a long bed, please upload the copy of your licence or a letter from your doctor here:
Residence Admissions will confirm receipt of your request once it has been received. Please note that the Manager of Residence Admissions may need to contact you if further information in required.  This form will only be viewed by the Manager of Residence Admissions to be used for the room assignment process. It will be kept strictly confidential, unless consultation or notification is required with Queen’s Student Accessibility Services and/or Campus Security & Emergency Services.   Please note that all requests will be considered on a case by case basis, based on reasonable accommodation practices for each individual’s needs.  Specific room type or building preferences are not guaranteed. Because individual assessments take time, please ensure your form is submitted by June 8th. While we will consider late submissions, appropriate room availability to meet your needs may be limited.
Personal information is collected under the authority of the Queen’s University Royal Charter, 1841, as amended, and will be used for residence room placement purposes. Questions regarding the collection or use of this personal information should be directed to the Return to Work and Accommodations Office at hrrtw@queensu.ca or 613-533-6000 x75792.