Initial Accommodation Request

* indicates a required field

Student Information

Please enter your information
Pronouns
Your student ID is a value that begins with the letter P. If you are a prospective student, please input your last name and your birthday formatted as MMDDYY  (ie: Smith123456)
Please use your university issued email address. If you are a prospective student, please use your preferred email address. 
Status (check all that apply):

Please select the campus where you are primarily enrolled.

Specific Accommodation Information

Have you received accommodations at Commonwealth University (Bloomsburg, Lock Haven, Mansfield) in the past?
Please include any functional limitations like concentration, comprehension, reading, hearing, etc:
Check the areas affected by your current disabilityRequired
Reasonableness will be determined on a case by case basis.
Are you requesting Housing Accommodations?Required

Academic History

Did you have an IEP, 504 Plan or some other school-based support?Required
DocumentationRequired
Upload supporting document(s)

Please upload documentation of disability from an appropriate professional, or forward separately to UDS. This could include a Psychological Evaluation, Psycho-educational Evaluation, Re-Evaluation Report, or other documentation. Please refer to https://www.bloomu.edu/offices-directory/disability-services for more information about documentation requirements.