Accommodation Request

* indicates a required field

Student Information

For Radford University or Radford University Carilion students with a disability who would like to request accommodations, please complete any information related to your disability. 

If you are here to request Alternate Learning options, contact your advisor. This form is no longer used to submit an alternate learning request.

Please use your university issued email address
In the Event of an On Campus Emergency:Required




Specific Accommodation Information

Please list accommodations you previously received related to this concern.

Functional Limitations - Academic

Calculating




Concentrating




Learning




Time Management




Reading




Stress Management




Taking Tests and Quizzes




Writing




Functional Limitations - Physical

Please indicate the level of impact on applicable major life activities due to the diagnosis(es).
Attending Class




Breathing




Caring for Oneself




Hearing




Seeing




Physical Tasks




Documentation and Submission

AcknowledgementRequired

Documentation examples include IEP, 504, psychological testing, doctor's letter

Acceptable formats include: .docx, .pdf.

How did you hear about the Center for Accessibility Services (CAS)?