Request for Accommodations - Forms - Title IX and Equity

How to know if a student qualifies for accommodations

Any undergraduate or graduate Northwest student with a documented disability (permanent or temporary) may be eligible for accommodations.

Keep in mind that having a disability does not mean a student is automatically approved for accommodations. All accommodations are determined on a case-by-case basis after a review of all relevant information. A staff member will work with the student to create an appropriate accommodations plan based on the student’s unique needs.

To make a formal request for learning or living accommodation(s):

Submit Accommodation Application

Students self-disclose the need for an accommodation, and must complete and then submit the fillable form. Accommodation applications (login required):

Submit supporting documentation

Students must also submit separately (emailed to ada@djycxmht.com), supporting documentation about your disability from your health or counseling professional.

For more information please see the documentation forms and guidelines guidelines in the sections below.

Follow up

Title IX and Equity, Accessibility and Accommodations staff will be in contact with next steps.

Disability Documentation Forms

Students who seek accommodations at the Northwest Missouri State University must provide documentation of their disability from an appropriate, licensed professional. The documentation must include the diagnosed condition, the treatment being provided (if any) and it can also suggest accommodations. Below are forms that licensed professionals can use to provide this information:

Disability Documentation and Requirements

A supporting letter completed by a licensed professional who is knowledgeable in the field of the student's particular disability.
Include a statement of diagnosis by the medical professional you are seeing.
Include the length of time the licensed professional has been treating the student for the disability; the number of visits with the licensed professional may also be required.
Include a description of the current status of the disability.
Relate how the student's disability affects his/her living or learning.
Recommend appropriate accommodations and state how they are remedial to the disability.
Be dated and signed by the licensed professional on agency letterhead (prescriptions are not accepted). Letter must be sent in WORD or PDF format as an attachment when emailed.
Initial supporting documentation must be no older than one year.

Title IX and Equity, Accessibility and Accommodations may request additional or more recent documentation as needed.

Confidentiality will be maintained for all documentation related to a student's disability.