Accommodations in College Housing

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This form will be sent to the Disability Resources located in the Library.

Name *

First

Last

Student ID # *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Contact phone *

If form is being completed by someone other than the student (with the student):

Person requesting accommodation

Relationship to student

Contact phone

Please describe the accommodation(s) you are requesting: *

Please explain why this accommodation(s) are needed. You need not provide detailed information about the nature or severity of the disability. *

Procedure for requesting an accommodation animal as an exception to the Residential Pet Policy

In reviewing requests for accommodation animals, the College consults as necessary with a wide variety of appropriate experts. Any resident wanting an accommodation animal to live in College Housing must prepare a written Request for Exception, which typically includes:

• A letter, written by the person requesting an accommodation animal, with an explanation of the disability-related need for the animal, the types of tasks, if any; the animal is trained to perform, as well as a description of the animal, including type and the animal’s name. If the resident’s disability is not readily apparent, the College requires appropriate medical documentation verifying the resident’s disability.

For Trained Service Animals (SA)

A service animal as a dog that is individually trained to do work or perform tasks for an individual with a disability. The task(s) performed by the dog must directly relate to the person’s disability. Students with service animals must provide proof that that the animal’s vaccinations required by state and local laws are up to date, submit a Service Animal Inquiry form answering the following questions:

a. Is the animal required because of a disability?

b. What work or task has the animal been trained to perform?

Emotional Support Animals (ESAS)

An Emotional Support Animal (ESA) is a companion animal that provides therapeutic benefit to an individual with a mental or psychiatric disability. The animal is not specifically trained to perform tasks for a person who suffers from emotional disabilities. Students requesting an ESA must submit the ESA Provider Request for Information Form and ESA Agreement Form (see ESA Animal Policy in SC4 College Housing).

All requests will be reviewed and the student will be contacted regarding the decision

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Accommodations in College Housing