Accommodation Request Form

* indicates a required field

Student Information

Is this your first time registering with the Office of Student Accessibility (OSA)?

First Name

Last Name

Middle Initial

Pronouns

Bison ID

Please use your university issued email address

Primary Phone Number

Secondary Phone Number

What semester are you requesting services for?

Emergency Contact

Name

Phone

Relationship

Disability Information

Select all documented disabilities that apply to you

Specify below if needed

Please describe the nature and extent of your disability

Describe the limitation imposed by your disability and how those limitations interfere with your ability to meet a specific academic requirement

Previous Accommodations

List accommodations received in previous academic environments. Write NA if not applicable

List the accommodations you are requesting

(e.g. additional time to complete exams, assignments, permission to record lectures, seating, etc...)

Upload supporting document(s)

This is a required step. Please see our website for more information regarding Disability Documentation.

Student Acknowledgements

I am responsible for contacting the Office of Student Accessibility (OSA) to request accommodations.
I am responsible for completing the intake forms and providing appropriate, timely documentation to the OSA office.
I am aware that if I drop or add classes, I am responsible for informing the OSA office.
I am aware that if I need to request a new accommodation, I must provide updated documentation and schedule a meeting with the OSA.
I am aware that it is my responsibility to contact the OSA if I am having any difficulties receiving my accommodations.
I am aware that the OSA is responsible for providing services for students with disabilities as per Howard University's procedure. As a result, faculty are not required to provide any accommodations without a plan from the OSA.

Rights and Responsibilities

Rights and Responsibilities of Students with Disabilities

As a student with a disability at Howard University, you have a right to:

The right to choose when and to whom they will disclose their disability.
Equal access to courses, programs, services, and activities offered by the University.
Reasonable accommodations and adjustments, when needed, to achieve equal access.
Decide whether to use the curricular and co-curricular accommodations for which you have been approved.
Seek resolution to concerns about access or discrimination through the University’s procedures for filing informal and formal grievances.
All other rights and privileges available to other students at the University.

As a student with a disability at Howard University, you have a responsibility to:

Meet qualifications of, participate in, and maintain the essential institutional standards for courses, programs and activities.
Self-identify to OSA as a qualified individual with a disability when an accommodation is needed and seek information, counsel, and assistance as needed and in a timely manner.
Demonstrate and/or provide documentation from an appropriately qualified professional explaining the way the disability limits participation in courses, programs and activities.
Follow University procedures for obtaining reasonable accommodations, academic adjustments, and/or auxiliary aids and services.
Inform OSA of any concerns about classroom accommodations, disparate or disparaging treatment related to disability, or access issues on campus as soon as the issue arises.

Rights and Responsibilities of the Office of Student Accessibility:

The Office of Student Accessibility has the right to:

Identify and establish the essential functions, abilities, skills, knowledge, requirements, and standards for courses, programs, services, and activities, in collaboration with campus partners, and to evaluate students on this basis.
Request and receive relevant documentation that supports requests for accommodations, academic adjustments, and/or auxiliary aids and services. The documentation must be from a qualified evaluator and meets the guidelines of appropriate documentation of the University. Suggested recommendation for accommodations must be clearly demonstrated in the evaluation.
Request outside review of documentation from a qualified evaluator in order to help determine reasonable accommodations.
Deny a request for accommodations, academic adjustments, and/or auxiliary aids and services if the information provided by the student fails to substantiate areas of functional impairment, the documentation provided does not adequately support the requested accommodation, or if you fail to provide appropriate documentation.
Deny a request for accommodations, academic adjustments, and/or auxiliary aids and services if will alter an essential course requirement or result in a fundamental alteration of a course, program or service, or poses an undue hardship on the University.
Approve and select reasonable, equitably effective accommodations adjustments, and/or auxiliary aids and services on behalf of the University.

The Office of Student Accessibility has the responsibility to:

Establish and disseminate criteria for the use of disability services.
Maintain appropriate confidentiality of student education records in compliance the Family Educational Rights and Privacy Act (“FERPA”) and other applicable laws and regulations.
Determine eligibility for participation of students with disabilities in the academic accommodations process based upon a review of appropriate documentation.
Ensure students with disabilities who self-identify and meet University criteria for eligibility to receive reasonable and appropriate accommodations, academic adjustments, and/or auxiliary aids based upon the individual's need.
Collaborate with faculty and staff regarding essential course and/or program requirements and appropriate reasonable accommodations.
Ensure that University courses, programs, services, and activities, when viewed in their entirety, are offered in the most integrated and appropriate settings.
Inform students with disabilities of university policies and procedures for filing a formal grievance through the Informal ADA Grievance Policy, the Formal Grievance Procedure and/or through external agencies (e.g., Office of Civil Rights).

Student Signature

By signing, I guarantee the information provided is correct to the best of my abilities and hereby give permission to the Office of Student Accessibility to release information to appropriate University personnel, to aid in the consideration and implementation of disability accommodations.