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Allen S Henry Bulding
Accessibility Resources Request Form

Appropriate documentation is required to determine the eligibility of educational accommodations. 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:

  • Diagnostic Impressions (including how the diagnosis may be a disabling condition and the functional limitations resulting from the disability).
  • Relevant Educational, Developmental, and/or Medical/Mental Health History.
  • Recommendations for 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.

  • If requesting an Emotional Support Animal (ESA), please complete the Accessibility Resources ESA Form with your provider as documentation of your need for the ESA.

After review of submitted paperwork, the Office of Accessibility Resources will be contacting you regarding eligibility, the possible implementation of accommodations, and any recommendations for interventions. If eligibility criteria are met, accommodations will be activated. Notification will be sent via email to the student and the faculty of the student’s current course load and/or academic program. Contacting each instructor to discuss the implementation of your accommodations is advisable. You are encouraged to contact the OAR with any questions and/or concerns regarding your accommodations.

I have read and I understand the eligibility criteria and documentation requirements set forth by the university to request educational accommodations, and I 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.

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