Request for Services and Accommodations

Individuals who wish to self-identify as having a documented need for accessibility services should complete the Request for Services and Accommodations Form with accompanying documentation on this page. The accommodations process can sometimes take several weeks, so beginning the process early is best. Planning ahead will help ensure that accommodations are in place the very first semester.
Documentation to support accessibility services must be completed by a credentialed professional and should be current, complete and appropriate. The Stephens College Student Handbook and the Employee Handbook (employee sign-in required) provide information regarding documentation. In addition, the Documentation Factsheet details a comprehensive list of required elements.
After receiving the Request for Services and Accommodations form and the supporting documentation, the ADA/Section 504 Coordinator will meet with the individual in person (or by Zoom video chat). At that time, the Coordinator will work with the individual to develop and implement an accommodation plan to best meet needs, and the individual will officially register for Center services.
After the initial registration process, students receiving services will reactivate accommodations through the ADA/Section 504 Coordinator at the beginning of each semester.

Student Responsibilities for ADA Accommodations

Students can request accommodations at any time; however, developing and implementing appropriate accommodations can require significant time and effort from multiple offices and individuals across campus, so a student’s prompt attention to the College’s requests for information and feedback are essential if a plan for accommodations is to be implemented in a timely, efficient way.

Students registered with the ADA/Section 504 Coordinator should communicate with their professors at the beginning of the semester to make arrangements for approved academic accommodations (e.g., testing or note-taking accommodations). In all cases, such arrangements should be confirmed in advance of when the requested accommodation will be needed.

For more information regarding the College’s ADA policies and procedures for students, please refer to page 37 of the Stephens College Student Handbook.

Request for Services and Accommodations Form

Instructions

If you need to make a new request for accommodations, complete the request form below.
If you need to renew/reactivate an existing accommodations (required each semester) OR make changes to existing semester accommodations, please contact the ADA/Section 504 Coordinator.

Email: [email protected]
Phone: (573) 876-7240
Office: Hugh Stephens Library Room 216

* = required field

Name *

First

Last

Preferred Name

Personal Pronouns

Email Address *

Birth Date *

YYYY

Address *

Street Address

Street Address Line 2

City

State / Province / Region

Postal / Zip Code

Country

Phone Number *

###

####

Please state your specific disability(ies).

Upload current, formal documentation of your disability(ies).

Allowed File Types: pdf

Please describe how your disability might affect your ability to access classes and/or the campus at Stephens College.

Please list the reasonable accommodations you are requesting in as much detail as possible. (Please note that the College may not be able to provide the specific accommodation you request, but may be able to provide a different accommodation to provide access.)

Semester, Year

For students only: please select one.

For the semester and year above, I wish to have my academic advisor and semester instructors and/or (if applicable) res life staff informed of my accommodations. For testing accommodations (if applicable), I understand that I must give both my instructors and the Student Success Center one week’s notice for regular tests and two weeks’ notice for midterm and final exams. Failure to do so may hinder my ability to access testing accommodations.

Do not inform my academic advisor or my semester instructors about my accommodations for the semester and year above.

For students only: In the event of a residence hall evacuation (e.g., fire, tornado, etc.), I wish to have Student Development and Safety & Security informed of my physical/medical disability. (Please note, Stephens College employees and residence hall staff are not necessarily trained to administer first aid (e.g., CPR, epi-pen administering, cortisol pen administering, etc.). If you have a medical diagnosis that you wish for Boone County 911 medical personnel to be aware of, please register for Smart 911 at smart911.com.)

Yes

Questions regarding this form and/or the College’s ADA Policy should be directed to the ADA/Section 504 Coordinator.
Email: [email protected]
Phone: (573) 876-7240
Fax: 1(800) 672-4318

1200 E. Broadway
Campus Box 2111
Columbia, MO 65215

I verify that my information is accurate and complete to the best of my knowledge.

Request for Services and Accommodations

Student Responsibilities for ADA Accommodations

Request for Services and Accommodations Form

Instructions

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