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Student Accessibility Services
Student Information

This form should be completed if you have the Course Policy Accommodation listed on your Accommodation Letter, and you would like Student Accessibility Services to contact your professors to arrange accommodations on your behalf. If you would prefer to communicate with your professors on your own, please see the information for Option 1.

Please note, you must already be approved for the Course Policy Accommodation before SAS can process this form. If your disability impacts course attendance and you have not yet discussed your concerns with an Accessibility Consultant, please contact SAS.

Current Condition

Please update us on the status of your disability.

When have you last had a flare up/change in your condition which impacted your coursework and/or course attendance? For how long did this flare up affect your ability to complete coursework or attend class? Please provide any other relevant information SAS may need to know that is specific to your current condition.

If you have not already done so, please read through the syllabi for each course to carefully consider what concerns you have specific to each course. SAS will reference the information provided when contacting professors to make arrangements for the Course Policy Accommodation.

Course Information 001

In the spaces to the right, please explain your concerns in the given area and whenever possible, please offer reasonable solutions* you would like SAS and your professor to consider. Please only select the areas in which you have concerns for this specific course.

Guidelines and Agreement

I understand that if I do not fill out this form with all necessary information, this may result in a delay in the processing of my request. I further understand accommodations may not fundamentally alter the core requirements of the course and the Course Policy Accommodation is not designed to allow students to miss an unlimited number of classes, assignments, projects, tests and/or quizzes.

I agree to communicate with my professors within 24 hours of a missed task if my disability affects my participation or attendance, and I will only use this accommodation for missed tasks related to my disability.


Signature entered here must exactly match the "Full Name" entered above.