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Accommodations Request

Please complete the disability services request form. In order for processing to begin, the form must be completed with all necessary information. Upon receipt of the completed application, allow up to 15 days to receive contact from Lessie Haney or Dr. Michael Ellison.

Preferred Method of Contact:
International Student:
Transfer Student:
Referred By:
Academic Status:
Student Classification:
Please specify your disability:
* Please note that if you have a condition that has not been present for more than 6 months or is not expected to affect you for more than 6 months, this is not covered under disability legislation. Disability Services will work with these individuals to accommodate their needs, though.
Do you receive services through any of the following:
Please list the accommodations that you are requesting at Texas Wesleyan University. Please note tha tyour documentation must support these requests:

By submitting this form, you are requesting reasonable accommodations for your disability (disorder, illness or condition) and you certify that all information provided is true to the best of your knowledge. You understand that, to receive reasonable accommodations, you must request reasonable accommodations in a timely manner, submit appropriate documentation of your disability, disorder, illness or condition as outlined in guidelines and forms from the Office of the Dean of Students, and must be found eligible for accommodations/services.