Accommodation Request Form

* indicates a required field

Please complete all fields on this Request Form providing as much information as possible. After reviewing this form the Accessibility Office will send an email requesting additional information (if needed) or instructions on how to schedule your one-on-one meeting with the Accessibility Office.

Prior accommodations at another institution or formal diagnosis is not required to complete this application or discuss accommodations. You may be eligible for limited or temporary accommodations while we process this request.
Changes to accommodations are not retroactive and go into effect only when approved by the Accessibility Office and notice has been sent to course faculty.
Accommodations and changes are implemented at the start of the new term or when logistically and reasonably possible.
Information concerning your disability will be treated confidentially and only shared Sonoran University employees who have a legitimate educational interest.

Legal First Name:

Legal Last Name:

Preferred First Name:

Phone Number:

Mobile Numbers are preferred

Email Address:

Please use your sonoran.edu email if one as been issued

Please enter your Sonoran Student ID#:

If you have not yet been issued a student ID# please enter your birthdate mmddyyyy

Medical Condition Disclosure

You will asked to identify any conditions, in no specific order, that impact your ability to access education effectively. If you have more than three conditions please list any additional conditions in the other comment box. The order of the conditions listed does not determine which accommodations will be applied.

Identify a diagnosed medical condition that is impeding your ability to access education effectively

Do you have another medical condition to identify?

If other was selected or more than 3 conditions have been diagnosed, please describe the medical condition(s) in detail:

Provide additional information about the conditions identified above, to help in determining appropriate accommodations:

Classify the severity of the identified condition(s):

Are any of the conditions temporary (9 months or less)

Are you requesting a religious exemption?

A signed letter of participation will need uploaded from a local religious leader identifying that you are an active member of the community.

Select the potential accommodation(s) you believe would be beneficial, based upon your prior experience:

Note: not all selections may be applicable or relevant to your program of study, and will be awarded based on confirmed diagnosis of a related condition

Upload supporting document(s)

Note: Medical documentation will be required to create an accommodation plan. However, temporary accommodations may be granted while appropriate documentation is being obtained, depending on the circumstances.

Accommodation Request Form

Medical Condition Disclosure

Document Information