Accommodation Request Form

* indicates a required field

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

  1. Accommodations Request Process: 

    1. Complete the Request Form in Symplicity (should form be capitalized?)

    2. Provide appropriate reasonable documentation of disability (read specific information below pertaining to each type of accommodation)

    3. Meet with CADR staff to determine reasonable accommodations 

  2. 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.

  3. Complex Accommodations Deadlines: Students requesting accessible course materials (braille, read aloud, captions, etc.), interpreters, or specialized classroom furniture, must allow no less than six weeks prior to the start of term to guarantee that the University will be able to meet the individual's accommodation needs from the start of the term.

  4. Priority housing accommodations: . Priority housing accommodations are available based on the schedule provided by the Office of Housing and Residence Life. Housing assignments for approved accommodations are made prior to the start of the standard housing process. If an accommodation request is submitted after the priority period, accommodations may be approved but are fulfilled based on space availability.  Should space be unavailable, students may elect to be placed on a wait list. 

    1. New Student Housing Information

    2. Returning Student Housing Information

STEPS to Request Accommodations

Request for Accommodation: Complete the form below. Providing detailed answers to questions enables CADR 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

I am seeking academic accommodationsRequired
I am seeking housing accommodationsRequired
I am seeking an Emotional Support Animal accommodation.Required
I am seeking a Residential Service Animal. Required
I am seeking dietary accommodationsRequired
Documentation

2. Gather 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. Gather documentation based on the specific type of accommodation you are requesting:

NOTE:  Prior to using any of the links below, log out of ALL Google accounts and all Google windows.  Log in only with your University of Lynchburg Google Account

  1. Academic Accommodations:

    1. Required Documentation:

      1. Students with a diagnosis of cognitive or learning disabilities who have diagnostic testing, generally from a private or school psychologist, should use Documentation Criteria, Diagnostic Testing for guidance. 

      2. Students with diagnosis of cognitive, medical, physical, mental health disability from a qualified provider should use the Documentation Criteria, Letter for guidance.

    2. Supplemental documentation may include educational or medical records; reports and assessments such as IEP, 504, professional observations; letters from physicians or treatment centers; veterans affairs or rehabilitation services; previous accommodations.

    3. Insufficient Documentation:

      1. Documentation on handwritten prescription pads or paper

      2. NCAA Athletic forms which may include diagnosis of disability information are generally not sufficient for accommodations, unless the physician has included a narrative statement of impacts and specific diagnosis. 

  2. Housing Accommodations: 

    1. Preferred: Download and have your provider complete the Housing Accommodation Verification Form. Please be sure to ask your provider to completely answer all questions. 

    2. Alternative: Have your provider create a letter of documentation, using Documentation Criteria, Letter for guidance.

  3. Dietary Accommodations:

    1. Preferred:  Have your provider complete the Dietary Accommodation Verification Form. Download the form and send it to your provider for completion.  Upon receipt from the provider, upload documentation to Symplicity (see below) .  Please be sure to request that your provider completely answer all questions. 

    2. Alternative: Have your provider create a letter of documentation, using Documentation Criteria, Letter

3. Upload documentation to Symplicity:

    1. Formatting - please make sure your documentation is legible (clear images, reasonable size for printing) and oriented vertically (Portrait).

    2. Log on to Symplicity with your University Google username and password.

    3. Go to the left menu and choose “Accommodations, Documents”

    4. Click on “Add New Accessibility Document”

    5. Title of the document should have your name first (Timmons, Julia), the name of the document (Academic Documentation, Etc.). 

    6. Skip Document type

    7. Drag the file from your desktop to the Document Box or click on Upload file, locate, and upload.

    8. Description is not necessary

    9. Skip Classification

    10. Skip Status

    11. Click Submit

4. Schedule Intake Meeting: CADR 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.

5. As needed PRINT a copy of these instructions for future reference. 

6. SUBMIT THIS FORM!!