Other Accommodation Request

Other Accommodation Request

If you would like to request an accommodation that does not fall under the categories of ESA/Service Animal, Single Room, or Academic accommodations, please use this form. Please find below the required forms that must be downloaded, completed, and then submitted through this electronic process to aid us in determining your eligibility for accommodations on campus. To download the PDF, right click on the form and click "Print".
1. Guidance Checklist form (Must be completed by appropriate professional)
2. Professional's Letterhead Diagnosis & Reccommendation (Must be written by appropriate professional)

3. Any additional relevant documentation that supports your request
(This section to be completed once all required documents are completed and ready for submission.)
Student Name*

First NameLast Name
FSC ID Number*
Mocs Email*
example@mocs.flsouthern.edu
Entry year at FSC*
Year (XXXX)
Phone Number*
Please enter a valid phone number.
1. Guidance Checklist form File Upload*

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2. Professional's Letterhead Diagnosis and Recommendation File Upload*

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3. Additional Relevant Support Documentation File Upload

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