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Request for Accommodations Form

This form is for use by students to self-identify their status as a person in the protected class of disability as well as to request access services, if needed.

The Accessibility Resource Center (ARC) facilitates services and accommodations for students with disabilities. Examples of covered conditions include: Attention Deficit/Hyperactivity Disorder (ADHD); autism spectrum disorders; chronic medical conditions (cystic fibrosis, diabetes); learning disabilities; mental health disabilities (bipolar disorder, depression, post-traumatic stress disorder); mobility disabilities (use of wheelchair or other assistive device); neurological disorders (traumatic brain injury, epilepsy, motor or tic disorders); orthopedic disabilities (bone or muscle disorders, connective tissue disorders); sensory disabilities (hearing, vision). Examples of accommodations include extended time for test-taking, accessible campus housing, transportation assistance, and textbooks in digital format.

If accommodations are needed, this form gives you, the student, the opportunity to give ARC additional information about your disability, the impact of the condition, the accommodations that you will need to address the impact, and the accommodations you have used in the past.

Please complete this form and submit it along with your disability documentation if you are requesting accommodations. The accommodation request process is finished when all the following steps have been completed:

1. Submission of this "Request for Accommodations" form.

2. Submission of current and comprehensive documentation that meets ARC guidelines.

ARC Documentation Guidelines

Documentation can be securely uploaded online with or after submission of this form, faxed to 414-229-2237, or mailed or delivered to Accessibility Resource Center, Mitchell Hall, room 112, Milwaukee, WI 53211.

3. You have met with an ARC staff person for an initial assessment interview.

Housing Accommodation Requests

  • For fall semester admission, first-year student requests for accessible housing and supporting documentation should be submitted to ARC by the priority deadline of June 1; transfer and graduate student requests should be made as soon after admission is possible.
  • For spring semester admission, all accessible housing requests should be made by the priority deadline of January 1.
While requests for disability services may be made at any time, we strongly encourage you to submit this request with your disability documentation as early as possible. Doing so will facilitate the timely provision of accommodations approved by ARC. Information provided to ARC is confidential.

Need more information? Contact the Accessibility Resource Center by emailing archelp@uwm.edu or calling (414) 229-6287.

PLEASE NOTE: Responses are required for all questions. Please use "Not Applicable" if the question does not apply to your situation.
Personal Information
  1. Note: Select when you would like to start your services.
  2. Note: Please select campus location where you will be enrolled.
  3. Hint: Enter 9 alpha numeric characters.
  4. Hint: Enter date in the following format Month/Day/Year (i.e. 12/31/2010).
Contact Information
  1. Hint: Enter 10-digit number only.
Local Address
  1. Hint: Enter zipcode as 97331 or 97331-0000.
Permanent Address
  1. Hint: Enter zipcode as 97331 or 97331-0000.
Additional Information
  1. Affiliation(s)
Questions
  1. Are you requesting accommodations or services from the Accessibility Resource Center (ARC)? Please select one of the following: *
  2. Which semester are you requesting accommodation services to begin? *
  3. How did you learn about ARC? (Please select all that apply.)
  4. What is your status at the University of Wisconsin-Milwaukee (UWM)? *
  5. What is your degree program? *
  6. Into which of the following categories does your primary disability fall? *
  7. Do you have a secondary disability? *
  8. Does your condition affect you in an academic setting? If so, please explain. *
  9. List the accommodations you are requesting in an academic setting (e.g. test-taking accommodations, books in alternate format). *
  10. Have you requested on-campus housing? If so, please specify building and room number. *
  11. Does your condition affect you in a residential setting (e.g. individual room/suite in residence hall)? If so, please explain. *
  12. List the accommodations you are requesting in a university-owned residential setting (e.g. strobe alarms, wheelchair-accessible housing), if applicable. *
  13. Do you need assistance during an emergency evacuation of a university-owned residential building? If so, please explain. *
  14. Does your condition affect your transportation needs (e.g. accessible parking, accessible shuttle)? If so, please explain. *
  15. Describe auxiliary aids, assistive technology, and/or services that you anticipate using while attending UWM (e.g. service dog, FM system, wheelchair) *
  16. List any accommodations and/or services you used in high school. *
  17. List any accommodations and/or services used in other colleges. *
  18. List any national standardized exams (e.g. SAT, ACT, GRE, LSAT, GMAT) you have taken and any accommodations used for each. *
  19. Please review the ARC documentation guidelines and submit appropriate documentation for your disability. In addition, please submit copies of IEP/504 plans and/or accommodation letters from national standardized exams. (Online submission using this site is a secure method of submitting documentation.) *
  20. I authorize ARC to discuss my documentation with the clinician who authored the documentation, or a similarly-qualified ARC clinical staff person or consultant, if additional information or clarification is required. *
  21. By submitting this form, I certify that the information provided on this form is accurate. I understand that to be eligible for access accommodations at the University of Wisconsin-Milwaukee, I must (1) submit this completed form, (2) submit documentation that substantiates the requested accommodations, and (3) participate in an individual assessment with an ARC staff person. *
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