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Appendix F: Unique Accommodation Request Form
Directions: If a student with a disability or an English learner requires an accommodation (i.e., a unique
accommodation) that is not listed in the PARC
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How to fill out unique accommodation request form

How to fill out a unique accommodation request form:
01
Start by obtaining a copy of the unique accommodation request form. You can usually find this form on the website of the organization or institution that requires it.
02
Read the instructions carefully to understand what information needs to be included in the form. Make sure to gather all the necessary supporting documentation or evidence that may be required.
03
Begin by providing your personal information such as your full name, contact details, and any identification numbers that may be required.
04
Specify the type of accommodation you are requesting. This could include specific accessibility needs, medical accommodations, or any other unique requirements you may have.
05
Detail the reasons or circumstances that necessitate the accommodation request. Be clear and concise in explaining why the accommodation is necessary for you.
06
If applicable, provide any supporting documentation or evidence that supports your accommodation request. This could include medical reports, letters from professionals, or any other relevant documents.
07
Submit the completed form along with any additional required documentation to the appropriate contact or department as indicated in the instructions.
08
Keep a copy of the completed form and any supporting documents for your records.
Who needs a unique accommodation request form?
01
Individuals with disabilities who require accommodations to access services, facilities, or participate in programs may need a unique accommodation request form. This form allows them to formally request the accommodations they need to ensure equal access.
02
Employees who require workplace accommodations due to a disability or medical condition may also need to fill out a unique accommodation request form. This allows them to formally request the necessary accommodations from their employer.
03
Students with disabilities who require academic accommodations in educational institutions may need to submit a unique accommodation request form to their school or university. This enables them to request the accommodations they need to succeed academically.
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What is unique accommodation request form?
The unique accommodation request form is a document that individuals can use to request special accommodations in a specific situation or circumstance.
Who is required to file unique accommodation request form?
Individuals who need special accommodations due to disabilities, medical conditions, or other circumstances are required to file a unique accommodation request form.
How to fill out unique accommodation request form?
To fill out the unique accommodation request form, individuals must provide information about their special needs, the type of accommodation requested, and any supporting documentation.
What is the purpose of unique accommodation request form?
The purpose of the unique accommodation request form is to ensure that individuals with special needs receive the necessary accommodations to participate fully in a specific activity or program.
What information must be reported on unique accommodation request form?
Information that must be reported on the unique accommodation request form includes details about the individual's special needs, the requested accommodation, and any supporting documentation.
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