Referral Form

Use this form to refer a student to Inclusive Education for support with their disability, impairment, chronic illness or injury. This is for referrals from Lincoln University staff only. Please do not share this form with students.

If your referral is urgent, please drop-in to see us in L010 on the Ground Floor of Ivey Hall (Library), email inclusive@lincoln.ac.nz, or phone +64 3 423 0087.

For medical support, please dial 111 (if urgent) or contact Student Health on +64 3 325 3835
Where do you work?
Do you have the student’s consent to refer them and share their information?
Why are you referring this student?
What support do you believe will help the student?