This Request for Accommodations form must be completed by the student requesting the accommodation(s). This information and the student’s signature are required so Disability and Access (D&A) staff has permission to speak with the University Extension (UEX) staff.

For non-UT and/or students not registered with D&A already, requests will not be processed until both the Request for Accommodations form and supporting medical documentation completed by a qualified clinical professional or health care provider have been submitted to D&A. Guidelines for documentation can be found on the D&A website under Forms & Documents.

Requests are processed within 5-10 business days once all materials are received. More information about the UEX accommodation request process can be found on our Online Learning page.