Accommodation Request Form

** Even if the accommodation is approved through this office, Housing may not necessarily be able to immediately fulfill your specific request. If that is the case you will be put on a waiting list.

Disability records are kept separate from academic, disciplinary and medical records to ensure each student’s privacy and confidentiality. No information is released without the knowledge and written consent of the student, except in those rare instances where disability services is required by law to reveal particular information.

Instructions for submitting documentation on the basis of a disability

Students requesting special consideration for housing based on a documented disability under the Americans with Disabilities Act must provide this form and documentation to Martha (Marty) Bledsoe, Director of Services for Students with Disabilities in Student Accessibility Services. All decisions are made on a case by case basis and are based on the severity of the disability and the documentation that accompanies the request. Please submit this form by fax (262-524-6892) or e-mail to mbledsoe@carrollu.edu. Letters purchased from the internet for a set price rarely provide the  information necessary to support an Emotional Support Animal request.

Appeal Process

If a student has been denied a disability determination or accommodation request, or if an accommodation approved by the Office of Services for Student with Disabilities has been denied by a faculty or staff member, the student has the right to appeal the decision. Students are encouraged to first meet with the Director of Disability Services to review the denial. The University has an obligation to provide reasonable and appropriate accommodations to ensure that otherwise qualified students with disabilities have access to all University functions. However, if the University can provide an accommodation that is equally as effective as the one requested, the University is not required to provide the requested accommodation.

Written Appeal to the Vice President for Student Affairs

The student may, within ten (10) days of a denial, submit a written appeal to the Vice President for Student Affairs. The written appeal should include a clear description of the reasons for the appeal and any supporting information. The Vice President will review the appeal and may solicit additional information from faculty and staff. The Vice President may affirm, modify or reverse the decision or, at his or her discretion, refer the matter to the Office for Services for Students with Disabilities for further review and decision. The Vice President will be responsible for generating a written decision within 30 days of receipt of the written appeal. The Vice President’s decision is the final decision of the University.

Appeal to the Office of Civil Rights (OCR)

Should the student disagree with the decision of the Vice President, they have the right to file an appeal with the Office of Civil Rights (OCR). Information on this process is available from the Customer Service Team - Office for Civil Rights, U.S. Department of Education, Washington, DC 20202-1100. Phone: 1-800-421-3481 TTY: 1-877-521-2172 E-mail: ocr@ed.gov

In compliance with Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act (ADA) of 1990, the University will not discriminate against or deny access to otherwise qualified students with disabilities. A reasonable accommodation is a modification or adjustment to a program, course or activity to enable an otherwise qualified student with a disability to participate in academic and activity programs at Carroll University. The University is obligated to provide reasonable accommodations only to the known, recognized limitations of an otherwise qualified student with a disability. Otherwise qualified students with disabilities who seek accommodation(s) must complete this form before requested, reasonable accommodation(s) can be reviewed and/or provided. If necessary, the student may be requested to provide additional documentation of his/her disability. If the University requires a second opinion, the student will be asked to undergo an independent medical exam (IME). The cost of the IME will be borne by the University. Failure by the student to provide necessary information or to undergo the IME can result in the denial of accommodation(s).

I understand that the provision of reasonable accommodation can occur only after the University has received a proper request from me, accompanied by all necessary documentation to support the need for accommodation. I also understand that receipt of reasonable accommodation(s) will occur only if I remain an otherwise qualified student at the University and if the requested accommodation(s) do not alter the fundamental nature of the course, program or activity in which I am enrolled, or pose a threat to the health and safety of others.

Please note: to determine reasonable accommodation(s), the Disability Services Director may seek information from appropriate University personnel regarding the academic and technical standards for affected programs, courses and activities.