Request for Accessible Educational Services

* indicates a required field

Student Information

What is your date of birth?Required
Please use your university issued email address, if you have one.
Please tell us the best number to reach you.
Do you have a university student ID number?Required
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Support Services Request

Have you received academic accommodations in another setting?Required
Do you need accommodations for New Student Orientation?Required
Do you use a service dog?
Housing Accommodation Only - Do you have an emotional support animal?
Do you receive Vocational Rehabilitation (VR) funding? Required

Medical Information

{"display_name":"What is your qualifying condition?","hidden_field_name":"ms_field_2","init_id":"ms_field_2","init_link":"","has_autocomplete":false,"has_hierpicklist":null}

Supporting Documentation

Upload supporting document(s)

Please attach documentation verifying your need to testing modifications or accommodations. See our website for details about acceptable forms of documentation. You may submit this later if documentation is not currently available, but please note your request will not be processed until appropriate documentation is received.

Maximum upload size per file is 3MB.

Additional Information