Welcome! We are excited to welcome you to Western as a Mountaineer!
Completing this Request for Disability Accommodations is the first of three steps to register with Disability Services:
- Complete this form, the Request for Disability Accommodations
- Provide documentation of your disability
- Complete an intake meeting with Disability Services the first week of classes (or whenever you register)
Please use this form to request the accommodations you may need at Western State Colorado University.
If you need assistance completing this form, please call or email Disability Services: 970-943-7056; arc@western.edu
This form is to be completed by the student.
What accommodations are you requesting? (Include academic, physical, communication, access needs, etc.) *This question is required.
Informed Consent for Information Release
I (signed below) hereby authorize Disability Services at Western State Colorado University to discuss, either in writing or orally, my academic accommodations with appropriate administrators, instructors, professors, and third-party service providers as deemed necessary by Western Disability Services staff for the purpose of providing and/or coordinating accommodations and services for me.
If you are using a screen reader and cannot sign this electronically, you can sign a hard copy in the Disability Services office.