Accommodation Eligibility Application

* indicates a required field

Student Eligibility Process

Requesting accommodations from Student Accessibility Services (SAS) is done in three steps:

1. Self-Identifying a Disability or Qualifying Condition

2. Documentation Review

3. Intake Interview

Unlike in elementary or high school, if a student with a disability believes that they need an accommodation, it is the student’s responsibility to self-identify their disability and the need for an accommodation.

To begin this process, submit the application below. Applications can not be submitted without documentation for review. If you do not have documentation or are in the process of obtaining it, reach out to us directly at sas@usm.edu.

Documentation requirements are detailed below for housing and academic accommodations. Once your documentation is reviewed and approved, you will receive communication via your USM email on how to schedule an intake interview. Accommodations cannot be approved without completion of this interview.

If you have any questions, do not hesitate to reach out to us directly by email (sas@usm.edu) or by phone at 601.266.5024.

Student Information

Please enter your information

First Name

Preferred Name:

Last Name

Middle Name

Student ID

ID needs to include W

USM Email

Please use your university issued email address

Phone Number

How did you find out about Student Accessibility Services?

Specific Accommodation Information

Please select your diagnosis or disability category:

Select all that apply

If other, please describe:

How does your disability or condition affect you?

Are you currently seeking treatment?

What accommodation(s) are you requesting?

Are you seeking housing accommodations?

Are you requesting maternity leave?

Documentation Guidelines

Documentation for SAS must be provided by a licensed or certified professional familiar with the student's qualifying condition.

It should include a statement detailing how the disability limits major life activities and participation in courses, programs, services, or activities, both with and without mitigating circumstances.

The documentation must be current (within five years), clearly stating the diagnosis and the condition’s impact on the student. While helpful, the university does not accept 504’s or IEP’s as documentation.

For Learning Disabilities (Autism, Dyslexia, etc.):

- The full diagnostic report from the medical provider or psychometrist.

For all other qualifying diagnoses:

- Documentation must be a letter from the provider, signed and dated on their letterhead within the past 5 years that clearly states their diagnosis.

For Pregnancies:

- We will need a letter from your provider that clearly states the beginning and ending dates of your maternity leave. It must contain the specific dates, not just a blanket “6 weeks” by the provider.

- Students are given the same amount of time that they are absent to complete any missing assignments o For more information, refer to the Title IX office.

For temporary diagnoses (broken bones, surgical recovery, etc.): All the same guidelines as regular diagnoses apply.

Upload supporting document(s)

Acknowledgement

I give permission for Student Accessibility Services to communicate information concerning my accommodations with individuals who will be involved in the delivery of accessibility services for my benefit. Any information provided will be kept private in accordance with ADA and FERPA. For more information on FERPA, or to complete a FERPA release form, contact the USM Registrar’s Office directly.