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Disability Services: Request for Accommodation Application

 William Jewell College is committed to ensuring that educational opportunities, programs, and services offered by the College are available and accessible to all individuals in accordance with Section 504 of the Rehabilitation Act of 1973, the Americans with Disabilities Act Amendments Act (ADAAA) of  2008, and the Fair Housing Act.


William Jewell College requires specific medical information from licensed professionals to be provided to the Office of Disability Services by those individuals making a request for an accommodation due to a disability*. The College uses this information to determine what, if any, accommodations would be most appropriate and reasonable. Under Section 504 of the Rehabilitation Act of 1973, and the Americans with Disabilities Act Amendments Act (ADAAA) of  2008, a person has a disability if he/she: 

  • Has a physical or mental impairment that substantially limits one or more of the major life activities. These activities can include but are not limited to walking, standing, seeing, eating, speaking, hearing, sitting, breathing, reading, learning, performing manual tasks, caring for oneself.
  • Has a record or history of such impairment; or
  • Is regarded as having such impairment.

Individuals requesting an accommodation should submit the following:

1.  The Request for Accommodation Form This link will direct you to the online fillable form.  Once submitted, this form will be forwarded to the Office of Disability Services. 

2.   A Comprehensive Medical Report.  This link will provide you with a printable instruction sheet for your medical provider.  A comprehensive medical report from an appropriate licensed medical professional is required as part of the Request for Accommodation application. This individual must have the necessary qualifications to accurately and properly diagnose the disability. This information should be dated within the past 18 months, though there may be times when the College can accept older documentation based on an individual’s specific circumstances. This information can be faxed to the Office of Disability Services at 816-415-5093.  The information can also be hand delivered to the office by the student making the request. This report should include:

  • A diagnostic statement identifying the disability, date of the current diagnostic evaluation, and the date of the original diagnosis;  
  • A description of the diagnostic criteria used to identify the disability including all diagnostic tests and results
  • A description of the functional impact of the disability;
  • Medications, treatments, assistive devices/services currently prescribed, including duration;
  • A description of the expected progression or stability of the impact of the disability over time;
  • Recommendation for accommodations, adaptive devices, assistive services, and support services;
  • The name and credentials of the diagnosing professional(s).

3. Prescription pad diagnosis does not qualify as acceptable documentation. The licensed medical professional must state the disability findings on official letterhead and include all of the requested medical information above. The College reserves the right to request additional information.

4. A list of guidelines for documentation of specific disabilities, such as Attention Deficit Hyperactivity Disorder (ADHD), Learning Disabilities, Medical/Physical Disabilities, and Psychiatric Disabilities can be obtained by visiting our website: Guidelines for Documentation.

5. Students wishing to file an appeal for exemption from the College's residency requirements or dining plan requirements due to a disability will follow the same process as those requesting an accommodation. If the appeal is based on an allergy, recent blood and/or skin test results will need to be included in the application. 

Once the information is received, (a) the individual is notified in writing that his/her request was received, and (b) the evaluation of the request begins immediately.

If the comprehensive medical report is not submitted via fax or delivered to the Office of Disability Services immediately following the online submission of the Request for Accommodation form, the student should promptly submit the information so that accommodation determinations can be made in a timely manner. Granted accommodations do not apply retroactively (meaning you will not be able to redo assignments or retake tests that you took before accommodations were granted) so any delay in providing necessary documentation could have significant academic consequences.

Accommodation determinations are made on a case-by-case basis, and supplying information does not guaranty any accommodations will be provided by the College. The College is not required to provide accommodations that fundamentally alter its programs.

Accommodation requests are accepted at any point during the school year. Please contact the 504 and Compliance Coordinator with questions or concerns. Disability Services is located in Gano Chapel Room 200, and is accessible by elevator. Further information regarding disability services can be found on our website: Disability Services   

*Certain disabilities do not require medical documentation, such as apparent physical disabilities. Please note this on the Self-Identification/Accommodations Request form included in this packet.

Mrs. Missy Henry
504 and Compliance Coordinator, Office of Disability Services
William Jewell College Phone (816) 415-7556 – Fax (816) 415-5093
henrymr AT william.jewell DOT edu

William Jewell College · 500 College Hill · Liberty, MO 64068


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