Accommodation Request Form

* indicates a required field

Student Information

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.

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Please use your university issued email address
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Date of Birth(Required) *
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Ex. Spring 2021
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[Select]

Health and Accommodation Information

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ex: Learning Disorder, ADHD, Epilepsy, Arthritis, Major Depressive Disorder, etc.
year, age, or grade
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?
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For a list of commonly requested accommodations, please visit our website.

Are you requesting housing-related accommodations? (Required) *

Impact

Please describe any ways in which your disabilities impact you in the following areas. If not relevant to your condition, type N/A. Be as thorough as possible, using your own words (do not copy/paste from your medical report).
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Including: reading, writing, math, spelling, listening, and note taking.

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Including: organization, time management, memory, concentration, and managing distractions.
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Including: managing stress, frustration tolerance, and social interaction.
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Including: walking, talking, hearing, seeing, sleeping, and writing quickly.

Free Response

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)
Diagnostician who diagnosed the disability
Other medical professionals

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.

Include all medical and psychological documentation, school records (high school or other college accommodation plans), or reports. Failure to submit all available records may delay your request. Review our documentation guidelines for more details.