Student Accommodation Request

Student, him or herself, should fill out this request completely. Please upload supporting documentation at the time of submitting this request.
* indicates a required field

Student Information

BEFORE COMPLETING THIS FORM, PLEASE READ: The STUDENT should complete this entire form, not a representative of the student. It is best to submit this request form AFTER you have committed to attend SMU. (Fall incoming students should submit starting in May, but be aware of the early deadline regarding any housing-related requests.)

Submit ALL of your supporting documentation at the bottom of this form.

*Tips* This form may time-out after 20-30 minutes or so. Also, it is best to complete the form from a PC or laptop.  

We look forward to working with you!

If you had accommodations at your previous institution, you should attach that letter at the bottom of this form.
ex: Fall 2020
ex: Fall 2020 or Spring 2021

Section 1: Health and Accommodation Information

ex: Learning Disorder, ADHD, Epilepsy, Arthritis, Major Depressive Disorder, etc.
year, age, or grade
If currently being treated by a doctor, please attach a current letter from that provider about your condition and its current impacts on you.
Please include whether you had accommodations in HS, other colleges, etc. and what those accommodations were. Be sure to attach that plan with your documentation. Explain if you received accommodations on HS standardized tests such as the STAAR, AP tests, or others.
Did you receive any accommodations on a standardized test, such as ACT/SAT/LSAT/GMAT? Required
If yes, please attach documentation of the approved accommodations at the bottom of this form.
Be as specific as possible, describing the actual request, not just the category (for example, request first floor residence hall vs. "housing"). Lack of detail may slow down the review of your request. Remember, the impact of your diagnosed condition must tie directly to the requested accommodation.
Are you requesting a housing-related accommodation?Required

If YES, you must review our website for critical information and deadlines, as well as a complete an additional self-report form: DASS Housing Accommodations Information

Please be sure that you are uploading the "Student Self-Report form for a Housing Accommodation"! We also strongly encourage you to have your provider complete the "Provider Verification of Disability-Related Need for Housing Accommodation" form. Both are found at the above link. Proceeding without submitting these forms could delay the review of your request.

Section 2: Impact

Please describe in your own words any ways in which your disabilities impact you in the following areas. Be as thorough as possible, and do not copy/paste from your medical report or simply state "see medical report". We want to hear the student's description of the impact in each area of functioning. Lack of detail could slow down the review of your request! If not relevant to your condition, type N/A. 

Including: impact in reading, writing, math, spelling, listening, and note taking.
Including: impact in organization, time management, memory, concentration, and managing distractions.
If requesting extended time for tests, be elaborate and specific in this section about how your disability impacts your speed of processing.
Including: managing stress, frustration tolerance, and social interaction.
Including: walking, talking, hearing, seeing, sleeping, and writing quickly.

Section 3: Free Response

Please include anything about yourself not covered here or in the documentation you submit If you are lacking a piece of documentation that will be forthcoming, you can note that here so we know you will be uploading it soon.

Section 4: Consent to Release & Documentation

DASS staff may find it helpful to consult with others about your disability and request for accommodations. To grant permission, check “Yes” and list the names of the individual(s) in the field.
Parent(s)/Legal guardian(s)
Diagnostician who diagnosed the disability
Other medical professionals
Upload supporting document(s)
Include all medical and psychological documentation, school records (high school or other college accommodation plans), or reports. Failure to submit all available records may delay your request. PLEASE combine all pages of the same report into ONE pdf document before uploading, instead of uploading individual pages/pictures as individual documents.