Skip Navigation

Disability Services

Disability Services Request Form

Consent of Requesting Party

To determine the eligibility of educational accommodations, appropriate documentation is required. Documentation presented must be written and signed by a qualified educational, medical, and/or mental health provider (including their professional credentials and contact information), and include the following:

  1. Diagnostic Impressions (including how the diagnosis may be a disabling condition and the functional limitations resulting from the disability).
  2. Relevant Educational, Developmental, and/or Medical/Mental Health History.
  3. Recommendations of Specific Educational Accommodations w/Supporting Evidence.

Educational and/or treatment records (i.e. 504 Plan, IEP, medical records, etc.) may also be provided, but does not serve as a substitute for a written letter or evaluation completed by a qualified provider.

After review of submitted paperwork, the Office of Disability Services will contact you regarding eligibility, the possible implementation of accommodations, and any recommendations for interventions. If eligibility criteria are met, accommodations are activated. Notification is sent via email to the student and the faculty of the student current course load and/or academic program. It is advised that you make contact with each instructor to discuss the implementation of your accommodations. You are encouraged to contact the Office of Disability Services with any questions and/or concerns regarding your accommodations.

I have read the eligibility criteria and documentation requirements set forth by the university to request educational accommodations, and I understand and agree to supply the required documentation in order to verify my disabling condition. The information contained in this form is current and accurate to the best of my knowledge.