The Office of Disabilities and Accessibility Services Registration Form

* indicates a required field

Student Accommodation Request

Please enter your information in the form below.

Welcome to the Office of Disabilities and Accessibility Services

Woodbury University is committed to providing students of all abilities access to all university programs, services, and activities as required by Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act. To make this possible, Woodbury’s Office of Disabilities and Accessibility Services (ODAS) grants reasonable accommodations to qualified students with disabilities.

This form is for Woodbury students – incoming, new, or current – who are making an initial request for accommodations through ODAS. Submission of this form is your official request to register with the Office of Disabilities and Accessibility Services (ODAS). Information provided will be used to establish ADA/504 eligibility and to develop appropriate reasonable accommodations. This form can be used for both academic accommodations requests and housing accommodations requests. If making a request for accommodations in housing, please be aware that this form does not secure your place in the dorm, and that you must separately complete a housing application as well.

This form allows you to provide relevant information regarding your disability, explain the functional impact of the disability in your own words, and upload any relevant medical documentation to provide verification of disability and further explanation. Once submitted, the ODAS Director will contact you via the email you provide to schedule an appointment to further discuss your request. If you have a Woodbury email address, please utilize that as your email address on the form for contact.

Please Note: This is only a request. Accommodations are not guaranteed until you have followed the necessary steps and have received official approval. You will be notified in writing (via email) of the decision to approve or deny your request. The University Grievance Procedure may be used to appeal any decision. Please direct any questions to disabilities@woodbury.edu.

*indicates a required field

First Name

Last Name

Student ID

Please use your university issued student ID. (Example: P000012345)

Please use your university issued email address. (Example: Woody.Owl@woodbury.edu)

Phone Number

Anticipated Graduation Date

Specific Accommodation Information

What is/are the nature of your disability/ies? (Select all that apply)

If you selected other please describe: (Enter N/A if not applicable)

Age of onset? (Enter N/A if not applicable)

What is your primary disability, condition, or functional imitation? (Enter N/A if not applicable)

What is your secondary disability, condition, or functional limitation? ( Enter N/A if not applicable)

I may have difficulty with: (select all that apply)

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How does your disability affect you academically?

How does your disability affect student life in general?

What accommodations would you like to discuss?

Please enter the name, phone number, and address of your doctor and/or specialist. (For informational purposes only.)

If you do not have a practitioner at this time, please note that below. ( Enter N/A if not applicable)

Have you ever been enrolled in any academic support programs? (e.g. IEP, 504)

Are you a Department of Rehabilitation client?

Student Disability Resources

Semester you would like your accommodation (s) to begin

Release of Preliminary Request for Services Information (Please Sign Here)

I understand that all of the information disclosed above is confidential and is collected in order to assist me at WU. I authorize WU Student Disability Resources to share my Preliminary Request for Services information with other WU employees on an educational and need-to-know basis.

Applying for Services Each Semester (Please Sign Here)

I understand that in order to apply for these services, I must contact the WU office for Student Disability Resources as soon as possible each semester after I enroll in courses. Depending on current circumstances, this may be completed as an in-person meeting if our campus is working under normal operations or it may be conducted via a video meeting or a phone appointment if we are working under remote service delivery operations.

Upload supporting document(s)

The Office of Disabilities and Accessibility Services Registration Form

Student Accommodation Request

Specific Accommodation Information

Document Information