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

Sonoran Email Address:

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

Personal Email Address

Please enter your Sonoran Student ID#:

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

For which academic offering are you currently enrolled or planning to enroll (Please check all that apply):

{"display_name":"For which academic offering are you currently enrolled\t\tor planning to enroll (Please check all that apply):","hidden_field_name":"ms_field_1","init_id":"ms_field_1","init_link":"","has_autocomplete":false,"has_hierpicklist":null}

Please indicate the quarter you currently enrolled for:

Who referred you to Accessibility Services?

Medical Condition Disclosure

The Accessibility Office works with students who have a disability as defined by the Americans with Disabilities Act and its Amendments. Generally, a disability is a physical or mental condition that substantially limits one or more major life activities. These activities can include things like seeing, hearing, walking, learning, communicating, thinking, concentrating, or performing daily tasks.

You will asked to identify any conditions, in no specific order, that impacts your ability to access education effectively. If you have more than 3 conditions please inform Accessibility Services. The order of the conditions listed does not determine the which accommodations will be applied.

What is your disability or diagnosis?

When was the disabilty or diagnosis identified?

Do you have another disability or diagnosis to identify?

Academics:

You will now be asked questions for the different academic categories for which accommodations are considered, namely:

-Didactic Exam and Classroom Accommodations

-Practical Exam Accommodations

-Milestone Exam Accommodations

-Clinical Accommodations

More information about accommodations in these academic categories is available on the Academic Accommodations please visit the Guide to Exams, Assessments, and Accommodations page on MySonoran (https://my.sonoran.edu/ICS/Students/Accessibility_Office_(ADA_Accommodations)/Guide_to_Exams_Assessments_and_Accommodations.jnz)

Students are encouraged to focus on the questions below for Didactic, Clinical, and Practical Accommodations, if at the start of the program, because these experiences occur immediately. Milestone Accommodations occur later in the ND program. Accommodation requests for Milestone can be requested now or addressed later by completing the Update form in Accommodate (Milestone accommodations need completed at least 2 quarters before scheduled Milestone exam date).

Please note that detailed, complete responses to questions will best help us evaluate your accommodation request.

Are you requesting Didactic Exam and Classroom Accommodations?

Are you requesting Practical Exam Accommodations?

Are you requesting Milestone Accommodations?

Are you requesting Clinical Accommodations?

Upload supporting document(s)

Upload below medical documentation from a medical doctor that including a clear diagnosis, the impact, and its severity for each disability or diagnosis selected earlier.

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.