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Housing Appeal Form-Medical/Financial

Medical/Financial Appeal Form ONLY

Documentation Requirements:
Documentation should be provided on official letterhead with the name, title, professional credentials, address, phone number, and signature of the evaluator, as well as the date of the report. No hand written notes or prescription pad notes will be accepted.
Please keep the following in mind:
  • Documentation should be submitted to Disability Services as far in advance as possible
  • Disability Services may ask for additional information if documentation is incomplete or does not support accommodation requests
  • Students who do not have documentation are encouraged to meet with the Disability Services staff to explore options for support
  • Documentation accepted by Western Colorado University might not be accepted by other institutions, agencies, and/or programs (e.g., testing agencies, licensure exams, and certification programs). Please check with the specific organizations and/or programs to determine their documentation requirements
Outside documentation should be current and the healthcare provider who has diagnosed the student or currently treating the student should be licensed either in Colorado or in the student’s home state.
*Due to potential conflicts of interest, documentation from the Western Colorado University Campus Clinic for the Center for Mental Health for the purpose of obtaining an ESA will not be accepted. However, students are encouraged to utilize these services whenever needed to ensure their ongoing health and well-being.


Deadlines for Medical/Financial on-campus Housing Appeal will be the following:

Deadline for Fall Semester-August 1st by 5 p.m. Mountain Time.
Deadline for Spring Semester-December 1st by 5 p.m. Mountain Time.

 
11. Documentation-Verification Files-Detailed On/Off-Campus Budget-Other *This question is required.