Request for Accommodation and Academic Support Disability Support Services

Student Information

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

1. Complete the questions on this intake form.

2. Submit documentation - You can submit documentation with this form, via email, fax, or deliver to our office.

3. Intake appointment - When eligibility is determined, you will be contacted to schedule an intake appointment. During this meeting you will discuss your goals at Walla Walla University and the assistance you may need in reaching them. An accommodations plan will be created to provide access to campus programs.

Contact disability.support@wallawalla.edu with any questions you may have.

First Name

Last Name

Middle Name

Student ID

Please use your university issued email address

Phone Number

Course of Study

Accommodation Information

My disability is

My disability category is

Briefly tell us how your disability impacts you

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?

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

Documentation Policy

Release of Information

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

Policy Acknowledgement

It is the responsibility of the individual student to provide documentation and request accommodation or auxiliary aides at least four (4) weeks before classes, programs, or activities begin to guarantee accommodation. Accommodations may be provided in a shorter time period, but it is important to allow adequate time for arranging accommodations. It is the student's responsibility to make written request assisstance in obtaining specialized support services from other resources such as: Vocational Rehab., Learning Ally, Services for the Blind, Veteran’s Administration, etc. For example, the Division of Vocational Rehabilitation (DVR) may help fund such items as tuition, textbooks, hearing aids, and other individually prescribed devices.

Request for Accommodation and Academic Support Disability Support Services

Student Information

Accommodation Information

Document Information