Public Accommodation Request

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Student Information

Please enter your information

Date *

First Name *

Last Name *

Middle Name

Date of Birth *

Student ID *

Email *

Please use your university issued email address

Phone Number *

Major *

Are you a veteran? *

Are you a client of Vocational Rehabilitation? *

Are you Deaf or Hard of Hearing? *

Are you currently enrolled? *

What semester are you requesting accommodations to begin? *

Accessibility Specific Information

Briefly describe why you are contacting Accessibility Services *

Disability Category *

Check all that apply

What is your formal diagnosis? *

Specific Accommodation Information

Parking Accommodations:

To request accessible parking, please submit a state-issued accessible parking permit to UVU Parking Services. State-issued accessible parking permits must be obtained through a state authorized agency. The Office of Accessibility Services does not handle parking-related requests.

Describe the functional limitations caused by your disability and how these limitations impact you in an academic setting: *

Please list the accommodations that you feel are necessary to allow you to access our curriculum and campus: *

Please describe how each accommodation relates to the functional limitations of your disability

Do you or have you used any adaptive technology or devices? If so, please describe what has been the most helpful:

Other Information

Please include anything else you would like OAS to know in order to best assist you:

Please list any questions you have about our services that we can answer for you:

Student Guidelines *

Listed below are the general guidelines of the Office of Accessibility Services (OAS) at Utah Valley University. Please read and type your name in the box below.

I understand that:

Ø It is my responsibility to provide accurate and timely documentation to OAS.

Ø It is my responsibility to check my UVU email and/or Accommodate portal for updates and announcements.

Ø Once my documentation is submitted and I have had a formal intake, the process can take up to three weeks to be completed.

Ø It is my responsibility to request accommodations each semester.

Ø I must notify OAS if I drop or add classes.

Ø It is my responsibility to ensure that my instructors have received my Letter of Accommodation.

Ø If I am requesting a new accommodation, I must provide updated documentation and meet with my OAS counselor.

Ø It is my responsibility to communicate directly with my instructors regarding exam accommodations and stay in communication about the time and place of such exams.

Ø It is my responsibility to contact OAS in a timely manner if I am having any difficulties securing or arranging accommodations.

Ø I am responsible for the condition and timely return of any equipment I use or borrow from OAS.

Ø If I am approved for note taking or audio recording services, I understand that these services are for my use only and may not be shared. In addition, I understand that I will only receive these services when I am present in class.

Ø Requesting accommodations does not mean that I will be approved.

Ø Some accommodations may be approved temporarily. This may be due to insufficient documentation and/or type of disability. In these cases, I will need to update my documentation to receive accommodations again. I understand that approval with be based on a review of the new documentation and there is no guarantee that the same or any accommodations will be approved.

Ø OAS does not provide retroactive accommodations.

Ø Faculty are not required to provide any accommodation that fundamentally alters the nature of their course or lowers their academic standards.

Ø Faculty are not required to provide any accommodation without receiving a copy of your current semester Letter of Accommodation at least one week in advance of a quiz or exam.

Ø It is my responsibility to ask the instructor of record whether other instructors or teaching assistants need to be informed of my approved accommodations. It is my responsibility to inform those instructors as well.

Ø Failure on my part to carry out any of these responsibilities may result in my inability to secure accommodations.

Typing your name in the box below acknowledges that you have read, understand, and agree to the guidelines of OAS.

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