The Office of Disabilities and Accessibility Services Registration Form

* indicates a required field

Student Information

Please enter your information

Welcome to the Office of Disabilities and Accessibility Services

This application is for students of any class standing (including newly admitted students and graduate students) who have not had accommodations in their classes before at Woodbury University. 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.

Once submitted, the Coordinator of Disabilities and Accessibility Services will contact you via the email you provide to schedule an appointment to further discuss your request. Supporting applicable documentation must also be submitted to ODAS before accommodations will be provided.

Please Note: This is only a request for registration. 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)

{"display_name":"I may have difficulty with: (select all that apply)","hidden_field_name":"ms_field_1","init_id":"ms_field_1","init_link":"","has_autocomplete":false,"has_hierpicklist":null}

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 Information

Specific Accommodation Information

Document Information