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Academic Success Center Accommodation and Accessibility Services 3rd Floor JFK Library Phone: 3044626051 Fax: 3044626032Accommodation Request Form Section 504 of the Rehabilitation Act of 1973 and
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Download the ADA accommodations request form-051717-1228pmscdocx from the designated website.
02
Fill out your personal information including name, contact information, and any relevant identification numbers.
03
Specify the type of accommodation you are requesting and provide detailed information about your disability or medical condition.
04
Include any supporting documentation or medical records that may be required to support your request.
05
Sign and date the form to certify that the information provided is accurate and complete.
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Submit the completed form to the appropriate office or individual according to the instructions provided.

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Individuals who require accommodations for disabilities or medical conditions in order to participate in certain activities or programs.
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It is a form used to request accommodations under the Americans with Disabilities Act (ADA).
Any individual who requires accommodations due to a disability.
The form can be filled out by providing personal information, details of the requested accommodations, and any supporting documentation.
The purpose is to request accommodations that will allow individuals with disabilities to have equal access to services, programs, and activities.
Personal information, details of the disability, requested accommodations, and any supporting documentation.
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