OSDAS Accommodation Request Form Powered by Symplicity

* indicates a required field

Student Information

Please enter your information

First Name*:

Last Name*:

Middle Name:

Student ID*:

Email*:

Please use your university issued email address

Phone Number*:

My diagnosed disability falls into the following category*:

How does your disability affect you academically?*:

What accommodations have you had in past educational settings?:

What accommodations do you believe will be helpful here at Regis?:

How does your disability affect student life in general, like taking tests and studying?:

Upload supporting document(s):

Please prove you are not a robot: