Accommodation Request

* indicates a required field

Student Information

Please enter your information
Enter your university email address.
IU School of Medicine students should select the IU Indianapolis campus on this form.
Are you currently a client of Indiana Vocational Rehabilitation (Voc Rehab)?Required
Will you be living in university housing in the coming/current year?Required
Are you a undergraduate, graduate or professional student?Required

Specific Accommodation Information

Enter a specific diagnosis (or diagnoses)
Please upload any supporting documents using the secure uploading utility.Required
If your documentation comes directly from your medical provider or if you do not have access to your documentation, please contact our office at 317-274-3241 or