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Disability Resource Center
Disability Resource Center – Getting Started
Disability Resource Center - Housing Accommodations
Disability Resource Center - Housing Accommodation Request Form
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Housing Accommodation Request Form
Housing Accommodation Request Form
Student First Name (preferred)
*
Student Last Name
*
Student Legal Name (if different from preferred)
Student ID#
Pronouns
(optional)
he/him/his
she/her/hers
they/them/their
Email Address
*
Phone Number
*
Current Hall Assignment (if assigned)
When will you first need this accommodation?
*
Summer 2025
Priority deadline has passed. Accommodations may not be finalized until the following semester.
Fall 2025
Spring 2026
Accommodation(s) Requested - Please check all that apply.
*
Wheelchair accessible residence
Visual alarms for the deaf/hard of hearing
Non-shared bedroom
Immediate proximity to shared bathroom
Adjoining bathroom (shared)
Adjoining bathroom (shared with only one roommate)
Dietitian referral to assess kitchen access needs
First-floor room assignment
Allergen-friendly roommate(s)
Emotional Support Animal
Other - Please indicate what accommodation is needed.
Enter other…
Please indicate the type and age of the Emotional Support Animal.
Describe how the accommodation(s) would impact your ability to fully participate in the University Housing program.
If an emergency arises in your building, will you need assistance exiting the building?
*
No
Yes, please add me to the Emergency Evacuation List.
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I understand that the Disability Resource Center may communicate with University Housing about my accommodation request.
*
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