Initial Accommodation Request

Disability TypeRequired *

Please select all that apply. .

[select]Attention Deficit/Hyperactivity Autism Spectrum Blind-Low Vision Chronic Illness Deaf-Blindness Deaf-Hard of Hearing Intellectual-Developmental Learning Mental Health Mobility Orthopedic Speech Temporary Traumatic Brain Injury clear

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Student StatusRequired *

Student Status Current Student Student Status Incoming First-Year Student Student Status Incoming Transfer Student Student Status NCAA Student-Athlete Student Status Graduate Student

CampusRequired *

Campus LUO (Online) Student Campus Residential Student

Did you request housing, dining, or support animal accommodations?Required *

Did you request housing, dining, or support animal accommodations? Yes Did you request housing, dining, or support animal accommodations? No

Are you requesting support animal accommodations?Required *

Are you requesting support animal accommodations? Yes Are you requesting support animal accommodations? No

Is the purpose of the animal as an Emotional Support Animal or a Service Dog?Required *

Is the purpose of the animal as an Emotional Support Animal or a Service Dog? Emotional Support Animal Is the purpose of the animal as an Emotional Support Animal or a Service Dog? Service Dog

Is the animal housetrained (able to control waste elimination)?Required *

Is the animal housetrained (able to control waste elimination)? Yes Is the animal housetrained (able to control waste elimination)? No

Is the animal crate-trained (able to consistently be confined to a crate without barking or whining)?Required *

Is the animal crate-trained (able to consistently be confined to a crate without barking or whining)? Yes Is the animal crate-trained (able to consistently be confined to a crate without barking or whining)? No

Has the animal been sterilized (spayed, neutered or other methods with documentation)?Required *

Has the animal been sterilized (spayed, neutered or other methods with documentation)? Yes Has the animal been sterilized (spayed, neutered or other methods with documentation)? No

Accommodations

[select]Extended time to turn in assignments 50% extended test time 100% (Double) Extended test time Textbooks in alternate format Closed captioning for all videos Transcription of audio-visual material clear

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