Initial Accommodation Request Form

Student Information

We know that seeking assistance can be overwhelming, but we’re here to help you!

This request form is meant for students requesting accommodations for the first time at Walla Walla University. If you have are already working with Disability Support Services and are requesting additional accommodations, please log-in to Accommodate and complete a supplemental request.

Please complete the form below to the best of your ability, answering every question. If you have any questions, please email dss@wallawalla.edu.

First Name

Last Name

Middle Name

WWU ID Number

Use your WWU ID Number

WWU Email Adress

Please use your university issued email address

Phone Number

Course of Study

Accommodation Information

My disability is

Diagnosis Status

My disability category is

How does your disability/diagnosis/condition impact you in a college setting?

If you are pre-diagnosis, self-diagnosed or in the midst of the diagnostic process, please describe the symptoms that are impacting your lived experience and/or academic experience.

Who referred you to our office?

If you selected other above, please describe who referred you

Did you have an IEP/504 plan/accommodations in high school or at another institution?

My accommodation request is for the following

What accommodation(s) are you requesting?

Documentation Policy

Where are you in the documentation process?

Upload supporting document(s)

Submit documentation from a qualified individual (medical practitioner) that establishes the nature of the disability. View specific documentation guidelines

If you are unable to upload documentation with this form, you can also submit documentation to:

disability.support@wallawalla.edu (email)

(509) 527-2090 (fax)

Disability Support Services

Walla Walla University
204 S. College Ave.
College Place, WA 99324

Release of Information

Please enter the name(s) of individuals who you give permission for us to share your information.

Policy Acknowledgement

Initial Accommodation Request Form

Student Information

Accommodation Information

Document Information