Miscellaneous Accommodation Letter Request Form

Miscellaneous Accommodation Letter Request Form

Instructions for Specific Colleges/Schools/Courses

GRADUATE STUDENTS: If applicable, request a letter for your Graduate Coordinator, Graduate Advisor, and the Graduate Studies Committee (GSC) Chair on the following page. Contact information can be found on the Graduate School’s Degrees & Programs website, and GSC Members in the University Catalog. If you are unsure whether this is applicable, please ask these specific faculty members in your graduate program if they need an accommodation letter for you first before submitting the form.

MEDICAL students do NOT request accommodation letters for your courses in the D&A Student Portal.

DELL MEDICAL SCHOOL: ONLY request a letter for your college contact Travis Crook.

COLLEGE OF PHARMACY: Request a letter for Renee Acosta (in addition to requesting regular Accommodation Letters through the D&A Student Portal).

SCHOOL OF NURSING: Request a letter for Vinh T Nguyen (in addition to requesting regular Accommodation Letters through the D&A Student Portal).

INCOMPLETE COURSE: Please complete the Incomplete Course section with appropriate course information. If you need to request accommodation letters for multiple incomplete courses, you should submit a request for each, individual course.

UNIVERSITY EXTENSION (UEX): Follow the process outlined on the D&A website: https://disability.utexas.edu/online-learning/

PLACEMENT EXAMS: Follow the process outlined on the D&A website: https://disability.utexas.edu/placement-exams/

WEB-BASED CLASSES: Request regular accommodation letters through the D&A Student Portal. If your class is entirely online, you may email your letter to your instructor but you still must communicate with them about which accommodations will apply in an online/web-based class.

Student Name:*

Student UT EID:*

Semester (Example: Spring 2025, Summer 2025):*

Student Email:*

Are you registered with D&A?*

Select

For what do you need an Accommodation Letter?*

Select or enter value

If applicable, please request a letter for your Graduate Coordinator, Graduate Advisor, and the Graduate Studies Committee (GSC) Chair.

First and Last Name 1:

Title 1:

First and Last Name 2:

Title 2:

First and Last Name 3:

Title 3:

If applicable, please request a letter for the below College contact.

Choose One Below:*

Select

Incomplete Course*

Are you needing to request an accommodation letter for an incomplete course from a previous semester?

Select or enter value

Course Abbreviation (e.g., CH 302)*

Course Unique Number (5 digits)*

Semester Course Take (e.g., Fall 2023)*

Instructor Name (First and Last)*

Reminders About Using Your Accommodations

Please read and acknowledge the following reminders about using your accommodations.

GRADUATE STUDENTS:*

I understand I will be notified via email when my Accommodation Letters have been processed and I will need to provide a copy to my requested college contact.

DELL MEDICAL/PHARMACY/NURSING:*

I understand I must download/deliver my Accommodation Letter to my requested college contact and discuss how I will receive my accommodations.

I acknowledge:*

I understand I cannot use my accommodations until I have delivered/discussed my Accommodation Letters with my requested college contact. I understand this is best done by appointment or during office hours to allow for greater discussion about how I will receive my classroom and testing accommodations.

I acknowledge: *

I will let my Access Coordinator know immediately if I experience any problems or concerns with an instructor or with using my accommodations in a class.

Reminders About Using Your Accommodations

Please read and acknowledge the following reminders about using your accommodations.

INCOMPLETE COURSE:*

I understand I must download/deliver my Accommodation Letter to the instructor for the incomplete course and discuss how I will receive my accommodations on the remainder of work to complete. I understand that these accommodations will only apply to any remaining work and will not be retroactively applied to work already completed.

I acknowledge: *

I will let my Access Coordinator know immediately if I experience any problems or concerns with an instructor or with using my accommodations in a class.

Want to register with Disability and Access?

In order to register for academic accommodations, you will need to follow the steps to register with D&A.  The first step is to submit documentation that meets our guidelines for verifying a disability, which differ depending on the disability category.

For further questions, you may contact our office at access@austin.utexas.edu or by phone at 512-471-6259.

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