Request for Accommodations Form

* indicates a required field

Student Information

Accessibility and Disability Resources (ADR) coordinates a number of direct services for undergraduate and graduate/professional students with disabilities or accessibility challenges. Accommodations are individualized based on a documented disability and the functional limitations of each student.

Step 1: 

Complete this Request for Accommodations Application. Make sure to complete every section; incomplete applications will not be reviewed. To apply, you must be currently enrolled at Azusa Pacific University.

Step 2: 

Along with your application, provide verification of a disability from a professional medical or mental health provider. Please see our documentation guidelines. Application and documentation may be submitted by uploading to this application or emailed to disabilityservices@apu.edu. You will receive an email if your documentation is insufficient so that you can resubmit appropriately. 

Step 3: 

Once your application and documentation are complete, you will be contacted within 3-5 business days to schedule an intake meeting. Students at Regional Campuses may schedule a phone or video-conference meeting.

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Please be aware that not all accommodation requests will be approved. ADR Staff will review your documentation and engage in an interactive process/intake meeting with you when determining and approving accommodations. In the event an accommodation is not approved, ADR Staff will provide you with information regarding your rights upon your request. 

The accommodation approval process may take several weeks. Upon approved accommodations, you will receive an email with your official accommodation memo. Your memo will also be emailed to appropriate APU faculty and/or staff. 

Once accommodations are established, they are applied proactively rather than retroactively, so planning ahead is very important. If you do not submit the required documentation within 30 days of applying, or the documentation is insufficient, your application will become inactive. You may re-apply at any time.

Application Info
Please use your university issued email address. Your APU email will be the main email ADR will use to contact you.
Date of BirthRequired
Preferred Method of ContactRequired
Are you transferring from another institution? Required
Are you involved in any clubs or organizations?Required
Here is a list of clubs and organizations: https://www.apu.edu/campus-life/clubs/list/
Are you employed?Required

Specific Accommodation Information

Are you applying for services due to COVID-19 and an underlying health condition?Required
Are you requesting an ESA?Required
Are you requesting a service animal?Required
Give examples of limitations you experience.
Check all that apply
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Upload supporting document(s)

In order to register with Accessibility and Disability Resources, students must provide supporting documentation containing a clear diagnosis from a treating professional for ADR review and determination of appropriate accommodations and services. To assist students with the process of obtaining documentation from their treating professionals, disability documentation guidelines are to guide the treating professional in clearly communicating the student’s disability limitations and needs. Students are encouraged to submit as much documentation as possible, even if the disability documentation does not meet all elements stated within ADR guidelines (i.e. IEP or 504 Plan). Provisional ADR services may be available during this process on a case-by-case basis.You can read the ADR documentation guidelines here.

If you choose to not submit documentation right now, you can submit at a later time by emailing disabiltyservices@apu.edu.

Release Authorizations

APU Accessibility and Disability Resources staff engages in an interactive and collaborative process with students in order to determine eligibility for reasonable accommodations. Part of this process includes the submission and review of documentation related to the reported disability or limitations. At times, additional information may be requested from treating professionals. Documentation provided to the ADR is confidential and only shared with other offices or personnel at APU as necessary to put accommodations into effect. The identification of your disability is kept confidential, however we may share the limitations as part of the interactive process. Disability information may be released only with expressed written permission of the student (which may include e-mail). 

Authorization AgreementRequired
PermissionRequired
I give permission to ADR to obtain information related to my disability from treating professionals.