Public Accommodation Request

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Student Information

Please enter your information
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Please use your university issued email address
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University Owned Housing Residents-In the event of an emergency(Required) *





Specific Accommodation Information

Previously Registered with CAS?(Required) *

I am already registered with the Center for Accessibility Services (CAS), but did not use accommodations last semester.

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

Acknowledgement(Required) *

If previously registered with the Center for Accessibility Services (CAS), no documentation is necessary unless there is a new diagnosis. 

 

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

Acceptable formats include: .docx, .pdf.

How did you hear about CAS?