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Student Accessibility Accommodation Request Form
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Student Information
Please enter your information
First Name
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Last Name
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Middle Name
Regis Student ID#
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Email Address
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Please use your university issued email address.
Phone Number
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Please indicate where your classes take place:
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Please indicate where your classes take place:
Weston
Please indicate where your classes take place:
Regis North (Lawrence)
Please indicate where your classes take place:
Regis Online
Specific Accommodation Information
My diagnosed disability falls into the following category
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Select all that apply:
How does your disability affect you academically?
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What accommodations have you had in past educational settings?
What accommodations do you believe will be helpful during your time at Regis?
How does your disability affect your life as a student? (Ex: Test taking, studying, etc.)
Upload Supporting Documents
Note: In order to be approved for accommodations, adequate medical/psychological or educational documentation must be submitted.
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