Disability Accommodation Request

Please complete this form which will be submitted to the Office of Academic Support and Access Services. Medical or other appropriate documentation of functional limitations must be provided to complete this request. Information contained on this form is CONFIDENTIAL, and will only be shared with persons involved in the review process. Your accommodation request will be processed ONLY when the requested documentation is provided. You may expect a response to this request within 10 working days of submission of this completed form and all supporting documents.