New Student Disability Accommodation Request Form

Instructions

Please complete this form if this is your first time requesting disability accommodations at OSU-Oklahoma City (OSU-OKC).

This form should take approximately 15 to 30 minutes to complete.

If you have any questions or need assistance, please contact the OSU-OKC Access & Community Impact Office at okc.accessibility@okstate.edu or 405-945-3385 and we will be happy to help!

We will reply to your email address listed on this form within two (2) business days upon submission of your request with approval status and next steps in the accommodation process, and we'll also email or call you with any questions.

As part of the admissions and enrollment process you will be asked to create and activate an institutional (okstate.edu) email address. Please be aware that your okstate email address is OSU-OKC's official way of communicating with our students and that we will begin sending all future email correspondence to your okstate email once it has been created.

Name and Contact Information

First Name

Preferred Name

Last Name

Personal Pronouns (Please check all that apply.)

he/him/his

she/her/hers

they/them/theirs

Student ID (CWID)

Student Email Address

Birthdate

Phone Number

Semester/Year of Accommodation Request

Are you officially enrolled in your courses? (If you have a class schedule for that semester you are officially enrolled.)

Yes

It's typically best to complete this form after you have enrolled in your courses. If you're experiencing any disability access issues during your admissions or enrollment process, please contact us at okc.accessibility@okstate.edu or 405-945-3385 and we'll be happy to help!

What semester and year are you requesting accommodations for? If the semester for which you are requesting accommodations is not listed, please do not fill out this form. Please email us at okc.accessibility@okstate.edu, and we will let you know when the form becomes available for future semesters. (Please select only one.)

Summer 2025

Fall 2025

Are you in the Center for Social Innovation (CFSI) program?

What is your disability? (Please focus on what affects your daily life the most and check all that apply.)

Chronic Medical

Arthritis

Cancer

Crohn’s Disease/Irritable Bowel Challenges

Diabetes

Fibromyalgia

HIV or AIDS

Migraines

Cognitive/Learning

ADD or ADHD

Autism Spectrum Disorder

Dyslexia

Learning Disability - Math

Learning Disability - Reading

Learning Disability - Written Expression

Mental Health

Anxiety

Bipolar Disorder

Depression

Post-Traumatic Stress Disorder (PTSD)

Schizophrenia

Neurological/Neuromuscular/Mobility

Brain Injury

Cerebral Palsy

Multiple Sclerosis

Muscular Dystrophy

Seizure Disorder

Spinal Cord Injury

Sensory

Blindness

Deafness

Hard-of-Hearing

Low Vision

Other disability:

**Please note that English as a Second Language is not considered a disability**

How does your disability affect you?

How does your disability affect your daily life?

How will your disability affect you in college?

What accommodation(s) are you requesting? (Please check all that apply.)

Extended time on all timed tests, exams, and quizzes, to be taken in a reduced-distraction setting

Time-and-a-half (additional 50% more time)

Double-time (additional 100% more time)

Permission to audio record class lecture content for note-taking purposes only

Request Power Point slides in advance

Reasonable Flexibility in:

Attendance policies in order to manage medical episodes or to attend health care appointments related to your disability

Coursework due dates in order to manage medical episodes or to attend health care appointments related to your disability

Attendance policies and coursework due dates in order to manage medical episodes or to attend health care appointments related to your disability

You have the following responsibilities with this accommodation for reasonable flexibility:

Talk with your instructor early in the semester about expectations of the course and how much flexibility in attendance policies and/or coursework due dates will be allowed.
Notify your instructor before class/due date whenever possible.

Accommodations for Deaf or Hard-of-Hearing

Access to Captioned Media

Sign Language Interpreter

Computer-Aided Real-Time Transcription (CART)

Assistive Listening Device

Reader on Exams, Quizzes, or Inaccessible Coursework

Screen reader compatible with your device

C-Pen for printed materials

Other accommodations:

Accommodation Letters

Our team confirms and approves the accommodations to be provided through Disability Accommodation Letters. These Accommodation Letters notify your instructors on what accommodations to provide and are sent directly to you and your instructors' okstate email addresses.

Once we agree on accommodations to be provided, we will prepare and send Accommodation Letters for your semester's classes within two (2) business days of approval if you are enrolled in classes that have already started.

If you are enrolled in classes that haven't started at the time of your accommodation request, we'll send out your Accommodation Letters approximately one (1) to two (2) weeks before their start date.

Do you need all of the accommodations you indicated above in all of your currently enrolled classes for the requested semester and year?

Yes

Please specify your accommodation needs for the requested semester and year's classes below.

For example:

I need the above indicated accommodations in ENGL 1113 (CRN 12345) only.
I need one specific accommodation for ENGL 1113 (CRN 12345).
I need all of the above indicated accommodations in all of my courses except ENGL 1113 (CRN 12345).

Documentation of your disability

Please provide us with documentation of your disability as part of the accommodation process. This documentation must be from someone who is qualified to diagnose or help you manage your disability and should not be from someone who has a personal relationship with you.

All documentation will be stored securely within the OSU-OKC Access & Community Impact Office.

If you don’t have documentation of your disability available right now, no worries! We’ll be glad to provide you with one semester of accommodations without this documentation to allow you time to obtain it. We’ll just need this documentation before we approve a second semester of accommodations and beyond.

Proper documentation should contain all of the following things:

Your first and last name
Your date of birth or your OSU-OKC Student ID Number
The date the documentation was prepared or written
- Please note that for Learning Disabilities the best practice is to provide documentation that is no older than five (5) years.
The first and last name of the person who prepared the documentation
The specific name of your disability, for example: ADD/ADHD, Learning Disability – Written Expression, Seizure Disorder, Bipolar Disorder, etc.
A description of how this disability affects your daily life, for example:
- Problems concentrating or maintaining focus
- Takes longer time to process information
- Periods of depression or mania
- Extreme fatigue, difficulty performing daily life activities
- Pain in hands when writing
The projected progression or stability of your disability (if not evident by the name of your disability or diagnosis)

How to submit documentation:

Email: okc.accessibility@okstate.edu
Book appointment to drop off in-person
Fax: 405-945-9127

Rights and Responsibilities of Students Receiving Disability Accommodations

I am aware that:

Accommodations are not retroactive and are in effect starting from the date on the Disability Accommodation Letter to the end of that listed semester.

It is my responsibility to contact OSU-OKC’s Access & Community Impact Office to request accommodations for each semester they are needed. For example, if you received accommodations for the Fall semester and want accommodations again for Spring, you will need to renew your accommodation request with our team by submitting a Current/Returning Student Disability Accommodation Request after you have enrolled for that semester.

The OSU-OKC Access & Community Impact Office can approve one semester of accommodations without appropriate documentation of my disability on file; however I will need to provide disability documentation before the OSU-OKC Access & Community Impact Office can approve a second semester of accommodations. I will contact the OSU-OKC Access & Community Impact Office if any issues arise that prevent me from obtaining that documentation.

It is my responsibility to contact the OSU-OKC Access & Community Impact Office if I need new accommodation letters due to a class schedule change or instructor change.

I am expected to meet OSU-OKC's essential academic, technical, professional, and behavioral requirements and standards.

If there is a problem receiving approved disability accommodations in my courses, it's a good idea to contact the instructor first, and that I can reach out to the Access & Community Impact Office if talking to the instructor does not resolve the issue.
I can initiate an appeal of any decision regarding my disability accommodations in alignment with the University's established grievance policies outlined in the Disability Services Policies and Procedures document.

By clicking “submit,” I certify that the information I provided about my disability is legitimate and that I have read my rights and responsibilities as a student receiving accommodations.