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Online Student Application

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STUDENT ACCOMMODATION REQUEST FORM

The Student Accommodation Request Form must be used when seeking accommodation(s) due to a documented disability. To make a request you must:

  • Review The University of Tulsa Accommodation Requests Policy and the Rights and Responsibilities of Students Using Accommodations Policy.
  • Complete this request form.
  • Submit a Student Accommodation Verification Form.

The information provided will assist the University in making decisions about appropriate accommodations. The University considers various types of information, including but not limited to, academic program requirements, functional limitations, student preferences, and factors that contribute to any functional limitations (see the University of Tulsa Accommodation Requests Policy).

  • I understand that I must have a qualified health care provider (e.g., Psychiatrist/Psychologist/Diagnosing Physician/Licensed Health Care Provider) complete and submit the Accommodation Verification Form and/or their own report documenting the conditions/diagnoses, functional limitations, and recommended accommodations. For requests for assistance animals, students should also ask their health care provider to fill out the Confidential Recommendation for Assistance Animal Form. These forms may be found online.
  • I understand the University of Tulsa will consider the accommodations as requested on this form and that copies of all documentation provided will be reviewed only by select administrators and others as reasonably practicable, as determined by the University.
  • BY SUBMITTING THIS APPLICATION I affirm that all personal statements and documents that I am submitting in support of my application are true and correct. I certify that I have read and reviewed the University of Tulsa Accommodation Requests Policy. I further certify that the information provided is accurate and true to the best of my knowledge and I understand that a misstatement or omission of fact may be cause for disciplinary action. I understand that falsifying or misrepresenting facts or information may result in disciplinary action. I authorize the Student Access and Accessibility Services staff to release limited medical-related information to the appropriate offices as it relates to my request for such accommodations. I further understand that The University is not obligated to provide any specific accommodation I request but will evaluate my request in light of all information available in making a determination of what is a reasonable accommodation.

Once you submit this form, a member of the Student Access office will contact you to schedule an appointment to discuss your accommodation needs. If in the meantime you have additional questions, please do not hesitate to contact Student Access.

Notice: Accommodation requests for the current semester must be submitted, in full (application and documentation), no later than the last day of classes. If you have an urgent, time-sensitive request for accommodations, please contact Student Access directly.
Personal Information
  1. Note: Select when you would like to start your services.
  2. Note: Select when you plan to graduate.
  3. Hint: Enter date in the following format Month/Day/Year (i.e. 12/31/2010).
Contact Information
  1. Hint: Enter 10-digit number only.
  2. Hint: Enter 10-digit number only.
Local Address
  1. Hint: Enter zipcode as 97331 or 97331-0000.
Additional Information
  1. Affiliation(s)
  2. Campus Location(s) *
Examples of accommodations that are offered. Please note this is a list of commonly requested accommodations and does not represent all of the accommodations that can be provided.

  • Extended time on exams
  • Testing in a distraction-reduced environment
  • Computer use for exams
  • Notetaking assistance
  • Recording lectures
  • Priority registration for classes
  • Documentation of ongoing medical absences
  • Notifications of allergies
  • Alternative formats
  • ASL interpreting
  • Preferential seating in classes
  • Housing and meal plan accommodations

Requesting Accommodations at Access

Questions
  1. Are you a University of Tulsa student athlete? *
  2. Have you received special services at a previous school?
  3. Do you have any other major illnesses/health issues/seizures/previous head injury? *
  4. By selecting YES and typing my name I affirm that all personal statements and documents that I am submitting in support of my application are true and correct. *
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