Accommodation Request

* indicates a required field

HWS Disability Services: Accommodation Request Form

First-Time Request Required *

This form is for first-time disability accommodation requests. If you have previously requested accommodations HWS, you will need to complete a Supplemental Request through Accommodation (instructions here).

Before completing, please note the following information:

Current HWS students are welcome to submit accommodation requests at any time during the academic year.

Incoming/ Transfer students can submit an accommodation request starting in June.

Please keep in mind that accommodations are not retroactive and are not automatically approved.

Each request is carefully reviewed, and approval is based on the provided documentation and individual circumstances.

If you have any questions or concerns, please email us at ctl@hws.edu.

I understand the above.

First NameRequired *

Last NameRequired *

Student IDRequired *

HWS EmailRequired *

Which category best describes your accommodation request?Required *

Which category best describes your accommodation request? Academic Request Which category best describes your accommodation request? Non-Academic Request Which category best describes your accommodation request? Academic AND Non-Academic Request Which category best describes your accommodation request? Temporary Request

My disability falls under the following category(ies):Required *

Select all that apply.

{"display_name":"My disability falls under the following category(ies):","hidden_field_name":"ms_field_1","init_id":"ms_field_1","init_link":"","has_autocomplete":false,"has_hierpicklist":null}

Academic Request:

Have you recieved academic accommodations in the past?Required *

Have you recieved academic accommodations in the past? Yes Have you recieved academic accommodations in the past? No

What accommodations or tools were most supportive?Required *

What are your academic strengths?Required *

Describe your academic strengths (e.g., writing, organization, solving problems)

What are some academic challenges you're facing right now?Required *

(e.g., managing time, keeping up with assignments, asking for help)

Have you used the CTL academic support system?Required *

(e.g. writing fellows, teaching fellows, study mentors)

Have you used the CTL academic support system? Yes Have you used the CTL academic support system? No

What was that experience like?Required *

Non-Academic Accommodation Requests

Non-academic accommodation requests are reviewed by the Non-Academic Accommodation Committee (NAAC), which includes representatives from various departments.

Requests are accepted on a rolling basis, but please be mindful of the following housing deadlines.

Housing Deadlines:

Fall Housing: February 15
Spring Housing: December 1
First Year/Transfer Students: July 1

Requests received after these dates may experience delays in processing and, if approved, implementation.

Have you received non-academic accommodations or support in the past?

Have you received non-academic accommodations or support in the past? Yes Have you received non-academic accommodations or support in the past? No

Please describe which accommodations were supportive.Required *

Please describe your current request.Required *

Temporary Request

Temporary medical conditions like injuries or post-surgery recovery aren't typically considered permanent disabilities, but HWS Disability Services can still offer temporary assistance to students dealing with such situations.

For temporary illness related questions, students can contact their dean.
If they have any questions, students can contact Disability Services at ctl@hws.edu.

What temporary accommodations are you requesting?Required *

When did the temporary condition or limitation begin or occur?Required *

What challenges are you facing because of this condition? Required *

e.g. difficulty walking to class, handwriting, etc.

How long do you expect this condition to affect your campus life?Required *

A week or less About 2 weeks 4 weeks or more Not sure

Have you been evaluated by someone on the HWS campus?Required *

Yes, by HUBBS Yes, by an HWS athletic trainer No, I was evaluated outside of HWS No, I haven't been evaluated

Documentation

Medical documentation (evaluations, reports) can assist in determining reasonable accommodations. Disability Services may request additional documentation as needed. If you have supporting disability documentation, please upload it below.

Non-Academic Documentation & Forms

Medical documentation (e.g., evaluations, reports) can help determine appropriate reasonable accommodations. Disability Services may request additional documentation if necessary. If you have supporting disability documentation, please upload it below.

Alternatively, your treating physician may complete the corresponding form provided here.

Upload Supporting Document(s)

Confidentiality StatementRequired *

By signing my name below, I hereby give permission to Disability Services (CTL) to give/receive information related to my disability for the purpose of providing disability related accommodations. I have been told that in order to protect the limited confidentiality of records, my agreement to obtain or release information is necessary, and that this permission is limited to the purposes of ensuring access and accommodations. I understand that by written statement, I may withdraw my permission at any time. I also understand that I may ask to see the information that is to be sent.

FEDERAL REGULATIONS PROHIBIT DISCLOSURE OF THIS INFORMATION WITHOUT YOUR SPECIFIC WRITTEN CONSENT.

Interactive Process

Meet with Shanelle France

The next step in your request is to meet with Disability Services to begin the interactive process. During this meeting, you’ll work with Disability Services to determine reasonable accommodations.

Meet With Shanelle France (open new window)

If you cannot find a meeting time, email CTL@hws.edu.

Meet with Thom Mascia

The next step in your request is to meet with Disability Services to begin the interactive process. During this meeting, you’ll have the opportunity to discuss your request and ask any questions you may have. Disability Services will provide further guidance and support.

Meet with Thom Mascia

If you cannot find a meeting time, email CTL@hws.edu.

Make sure to come back and hit submit!!

Accommodation Request

HWS Disability Services: Accommodation Request Form

Document Information