Accommodation Request Form

Student Information

CURRENT CMU STUDENTS: Please enter your information below. Students should be the one to complete this entire form, not their representative.

At the end of this form, you will be asked to provide documentation of your disability. It is helpful to have this documentation ready prior to beginning this form.

INCOMING FALL 2025 STUDENTS: Please note that we will begin processing new requests in late spring and throughout the summer. Be sure your CMU Global ID and student ID number are accurate. We will reach out via your CMU email address with any file updates and to schedule meetings.

NOTE: This form times out after one hour. Please be sure to submit the form within one hour to avoid losing the info you have entered.

Global ID (smith1mv)

First Name

Middle Name

Last Name

Campus ID number (1234567)

Email

Please use your university issued email address

Cell Phone Number

Date of Birth

Enrolled at CMU as

If you are a transfer student, from which college or university are you transferring?

I was admitted to CMU as

Who referred you to SDS?

Health and Accommodation Information

Please list your diagnosed conditions (include all that apply)

ex: Learning Disorder, ADHD, Epilepsy, Arthritis, Major Depressive Disorder, etc.

When were you first diagnosed?

year, age, or grade

Current medications and/or treatment and side effects

History of accommodations and/or support services

Please include whether you had accommodations in HS, other colleges, etc. and what those accommodations were.

Did you receive any accommodations on a standardized test, such as ACT/SAT/LSAT/GMAT?

What disability-related accommodations are you requesting at CMU?

For a list of commonly requested accommodations, please visit our website.

Are you requesting housing-related accommodations?

Impact

Describe how your disability impacts you in these areas if any.

Cognitive/Academic

Including: reading, writing, math, spelling, listening, and note taking.

Executive Functioning

Including: organization, time management, memory, concentration, and managing distractions.

Emotional

Including: managing stress, frustration tolerance, and social interaction.

Physical

Including: walking, talking, hearing, seeing, sleeping, and writing quickly.

Free Response

Is there anything else you want us to know?

Please include anything about yourself not covered here or in the documentation you submit.

Consent to Release & Documentation

SDS staff may find it helpful to consult with others about your disability and request for accommodations. To grant permission, check “Yes” and list the names of the individual(s) in the field.

Parent(s)/Legal Guardian(s)

Parent(s)/Legal guardian(s) Name

Diagnostician who diagnosed the disability

Diagnostician Name

Other medical professionals

Name(s) of other medical professionals

Consent for Services

Your confidentiality is important to us. Please be advised that FERPA does allow us to share information within CMU with other employees who have a legitimate educational interest in the information. For example, if you are requesting a housing accommodation, we will be in communication with Residence Life.

Upload supporting document(s)

If you do not have your documentation ready to submit now, you will need to email it to SDS@cmich.edu once you have it.