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New Student Disability Accommodation Request Form
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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.)
Personal Pronouns (Please check all that apply.)
he/him/his
she/her/hers
they/them/theirs
Email Address
Student ID (CWID)
Birthdate
Birthdate
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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.)
Are you officially enrolled in your courses? (If you have a class schedule for that semester you are officially enrolled.)
Yes
No
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? (Please select only
one
.)
What semester and year are you requesting accommodations for? (Please select only
one
.)
Fall 2024
Summer 2024
Are you in the
Center for Social Innovation (CFSI)
program?
Yes
No
What is your disability? (Please focus on what affects your daily life the most and check all that apply.)
Chronic Medical
Chronic Medical
Arthritis
Cancer
Crohn’s Disease/Irritable Bowel Challenges
Diabetes
Fibromyalgia
HIV or AIDS
Migraines
Cognitive/Learning
Cognitive/Learning
ADD or ADHD
Autism Spectrum Disorder
Dyslexia
Learning Disability - Math
Learning Disability - Reading
Learning Disability - Written Expression
Mental Health
Mental Health
Anxiety
Bipolar Disorder
Depression
Post-Traumatic Stress Disorder (PTSD)
Schizophrenia
Neurological/Neuromuscular/Mobility
Neurological/Neuromuscular/Mobility
Brain Injury
Cerebral Palsy
Multiple Sclerosis
Muscular Dystrophy
Seizure Disorder
Spinal Cord Injury
Sensory
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
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
Reasonable Flexibility in:
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.
Learn more about this accommodation and other frequently asked questions by visiting
Student Frequently asked Questions (FAQ)
.
Accommodations for Deaf or Hard-of-Hearing
Accommodations for Deaf or Hard-of-Hearing
Access to Captioned Media
Sign Language Interpreter
Computer-Aided Real-Time Transcription (CART)
Assistive Listening Device
Reader and/or Scribe on Exams, Quizzes, or Inaccessible Coursework
What is a Reader/Scribe?
A reader is someone who reads the content of the material aloud to the student.
A scribe is someone who writes down or indicates the student's answers to the coursework exactly as dictated.
Readers and scribes do not assist the student in clarifying any questions related to the coursework, provide tutoring, or otherwise help the student obtain answers to the coursework.
These accommodations are typically utilized by students who have difficulty using their hands, vision loss, or disabilities that involve reading.
Close
Reader and/or Scribe on Exams, Quizzes, or Inaccessible Coursework
What is a Reader/Scribe?
A reader is someone who reads the content of the material aloud to the student.
A scribe is someone who writes down or indicates the student's answers to the coursework exactly as dictated.
Readers and scribes do not assist the student in clarifying any questions related to the coursework, provide tutoring, or otherwise help the student obtain answers to the coursework.
These accommodations are typically utilized by students who have difficulty using their hands, vision loss, or disabilities that involve reading.
Close
Reader
Scribe
Reader and Scribe
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?
Do you need
all
of the accommodations you indicated above in
all
of your currently enrolled classes for the requested semester and year?
Yes
No
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)
You can also use our
Disability Documentation Form
to give to your health care provider or diagnosing professional.
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.
A complete Disability Services Policies and Procedures document is available on the Access & Community Impact Office website at
https://osuokc.edu/disability/policies
.
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.
Please click "Submit" to complete your New Student Disability Accommodation Request.
Submit
