Public Accommodation Request

* indicates a required field

Student Information

Please enter your information
(Begins with an "A" and is followed by nine numbers, you can complete this form once a student ID number has been created for you)
(SRU email REQUIRED)
(Area Code) XXX - XXXX
Have you previously received accommodations?Required
Are you working with the Office of Vocational Rehabilitaion (OVR) or another vocational rehab office?Required
Are you working with Veteran's Affairs?Required
Are you requesting a housing accommodation?Required
Are you requesting an emotional support animal (ESA) to reside on campus with you?Required

Specific Accommodation Information

Please describe the accommodations you are requesting at this time. Accomodations will be discussed in your welcome meeting. All accommodations are assigned on a case-by-case basis.
Upload disability support document(s)
See documentation guidelines on our website at www.sru.edu/ods. Photos of documentation will NOT be accepted. Please scan and attach, or fax to 724.738.4399

By typing my initials in the box below, I authorize the Office of Disability Services at Slippery Rock University to disclose educational, psychological, and medical records or information that would assist the university in the design of reasonable accommodations to my disability.  

By typing my initials in the box below, I authorize the Office of Disability Services at Slippery Rock University to receive educational, psychological, and medical records or information that would assist the university in the design of reasonable accommodations to my disability.