Accommodation Request Form

* indicates a required field

University of Lynchburg is committed to providing equal access and equal opportunity to students with disabilities. Accessibility and Disability Resources staff works with students on an individualized basis through an interactive process for determination of accommodations.

Timing of Requests: Requests for accommodation can be made at any time. Students requesting accommodations must allow no less than two weeks prior to the start of the term in order to meet an individual’s accommodation needs from the start of the term.

Request for Accommodation: Complete the form below. Providing detailed answers to questions enables ADR to best understand your accommodation needs.

If you do not have a preferred name, please enter your first name.
Please use your university issued email address

Specific Accommodation Information

Do you use any technology to manage your disability?Required
I am seeking academic accommodationsRequired
I am seeking housing accommodationsRequired
I am seeking an Emotional Support Animal accommodation.Required
I have a Service Animal. Required
I am seeking dietary accommodationsRequired
Documentation

Upload Documentation:  In circumstances where either your disability and/or requested accommodation is not obvious, you must provide documentation from a reliable third-party (e.g., a physician or other medical professional), establishing that you have a disability and that the accommodation is necessary to provide you an equal opportunity.

Schedule Intake Meeting: ADR will receive notifications when you complete the Request Form and when you upload Documentation.  We will reach out to you to schedule your Intake meeting.

Don't forget to hit submit!