Request for Accommodations

Request for Accommodations
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Is this request for the Fall, Spring, or Summer semester?
This form is used to request student's Letters of Accommodations for their classes at John Melvin University. Letters of Accommodations refers to the accommodations the student has been approved for by the Office of Disability Services through the interactive process.

Student Responsibilities:

1. Accommodations must be approved by the Office of Disability Services at John Melvin University.

2. Letters of Accommodations will be provided to students who are currently enrolled for the classes requested below at John Melvin University.

3. Classes enrolled in after the submission of this form will require a new request form to be submitted for the newly enrolled classes.

4. It is recommended that students see the Office of Disability Services at least once each semester. Any change in accommodations will require counselor approval.

IMPORTANT:
Your Letter(s) of Accommodation(s) will be sent to your preferred email on file in . If you do not see the email within 1-2 business days please check your spam or junk folder in the event the email was blocked. Please contact the Office of Disability Services if you need additional assistance.
Specify your disability type (check all that are applicable):*

Blind or Low VisionDeaf or Hard of HearingTraumatic Brain InjuryPsychologicalChronic Health ConditionPhysicalLearning DisabilityOther
The University will consider your request in light of your disability, as described in your documentation and other information provided to us, as well as the requirements of your specific academic program. If you are not familiar with the accommodations process, or believe you will require unique accommodations, please contact our office to schedule an appointment. We are always happy to discuss potential accommodation solutions that align with your disability related needs.
Please upload IEP and/or Doctor's diagnosis of Disability:

Cancelof
If applicable, please provide information about your history of receiving accommodations. Please note, a history of accommodations, or lack thereof, does not necessarily guarantee (or exclude) provision of accommodations at John Melvin University. Please provide a letter confirming your accommodations at previous institutions including the following: previous school/program, dates attended, and approved disability accommodations.
I understand that it is my responsibility to provide disability documentation consistent with John Melvin University practices for documentation in order to establish eligibility for services. I understand that review of my documentation is applicable only for providing services and accommodations at John Melvin University and may not be accepted by any other institution or testing agency.

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