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Disability Services: Request for Accommodation Application and Instructions


Request for Accommodation Process for Students, Faculty, and Staff

William Jewell College requires any individual requesting an accommodation to complete a two-part application process.  This process is conducted through an interactive exchange between the individual, the 504 and Compliance Coordinator, and other essential personnel specifically involved with implementing the accommodation.  This process allows the College to determine what, if any, accommodations would be most appropriate and reasonable. Accommodation determinations are made on a case-by-case basis for otherwise qualified individuals, and supplying information does not guaranty that accommodations will be provided by the College. Applications will not be processed until both steps (1 and 2) are completed and submitted to the Office of Disability Services (please see instructions on submission below). 

 1.  Request for Accommodation FormThis link will direct you to the on-line fillable form. Once submitted, this form will be forwarded to the Office of Disability Services. 

 2.  Supporting Documentation. This link will provide you with a printable instruction sheet for your medical provider, should the provider need guidance on documentation requirements for this process.  Supporting documentation from an appropriate licensed medical or educational professional is required in order to substantiate an individual's request for an accommodation. This individual must have the necessary qualifications to accurately and properly diagnose the disability. The information required to support the accommodation request will vary depending on the nature of 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 or can be mailed to Office of Disability Services, Box 1009, 500 College Hill, Liberty, MO 64068. Generally, 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; please make sure and include a rationale for each individual accommodation that is being requested
  • The name and credentials of the diagnosing professional(s).

3.  Once the application has been completed and submitted to the Office of Disability Services, (a) the individual is notified by email or phone that his/her request was received, and (b) the evaluation of the request begins immediately.  Upon completion of the application review, the 504 and Compliance Coordinator will schedule a meeting to discuss and review the information from the application and the next steps in the accommodation process. 

 4.  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 medical and/or educational information if needed to satisfy established documentation requirements.  


Special Guidelines for Students Requesting Accommodations

1. While accommodation requests are accepted at any point during the year, it is advised that individuals submit their application well in advance of the start of the upcoming semester, as some accommodation requests can take up to 6 weeks to complete. It is strongly advised that any individual needing accommodations submit their application by June 1 for the upcoming Fall semester and Oct 1 for the upcoming Spring semester.

2. Granted accommodations do not apply retroactively (meaning an individual will not be able to redo assignments or re-take exams that were taken before accommodations were granted) so any delay in providing necessary documentation could have significant academic consequences.

3. 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.

4. The supporting documentation provided for purposes of an accommodation request cannot be from the parent of the student making the request, even if he/she has appropriate credentials.

5. Students who receive approval for any academic or classroom related accommodations, will receive a "Statement of Accommodation" for the current semester for which they are enrolled.  This information is provided to faculty members and advisors upon issue of the statement, with approval from the student.  Students must request academic or classroom related accommodations for all subsequent semesters that they are enrolled. 

6. Students who receive approval for any housing and/or dining accommodations, will receive a notification letter from the 504 and Compliance Coordinator or the Director of Residence Life. While students are not required to re-qualify for disability related accommodations, they should continue to provide their request in writing to the 504 and Compliance Coordinator for each subsequent academic year that they are enrolled. Because accommodations are provided on a first come first serve basis, students should make their requests no later than June 1st for the upcoming academic year.

Contact Information

Any additional requests or questions regarding programs, services, and activities accessible to and useable by persons with disabilities, should be directed to the 504 and Compliance Coordinator:

Mrs. Missy Henry 
504 and Compliance Coordinator, Office of Disability Services
500 College Hill
Campus Box 1009 
Liberty, MO. 64068
Office Phone- (816) 415-7556 Office Fax- (816) 415-5093 
Email Address-
 henrymr AT william.jewell DOT edu 

The Office of Disability Services is located on the 2nd floor of Gano Chapel, Room 200. This office is accessible by elevator, which is located in the East corner of the building on the main floor. Office hours are 8:00 a.m. to 3:00 p.m. Monday through Friday.

*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.


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


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