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Disability Services
SSCB 1.301

Phone: 281-283-2648
Fax: 281-283-2624

Fall and Spring Semesters
Mon - Thu: 9:00 am - 7:00 pm
Fri: 8:00 am - 12:00 pm

Summer and Semester Break
Mon - Thu: 8:00 am - 6:00 pm
Fri: 8:00 am - 12:00 pm

New UHCL Students Request for Accommodations

Initial Accommodation Request

To receive accommodations, you must do the following:

  1. Complete the form below
  2. Provide documentation of your disability
  3. Meet with a Disability Services Staff person
    You can schedule an appointment by coming to Disability Services or calling 281-283-2648

Accommodation letters should be available within a week and are implemented as soon as reasonably possible.

All fields required, unless otherwise stated.

Personal Information

Optional Demographic Information
Gender Identity


Select all that apply



Are you a U.S. citizen or a permanent resident?

Veteran Status

Are you a veteran?

First Generation Student

Are you a first generation student?

Disability Information

Academic Information

Academic School

Check all that apply.

Degree Sought


Class Locations

Check all that apply.

Types of Classes:

Student Responsibilities Agreement

Student Responsibilities Agreement (pdf)

I acknowledge my responsibilities as a student to the faculty and Disability Services. To implement effective accommodation, I recognize I must engage in a collaborative process with my instructor and Disability Services.

As a qualified individual seeking accommodations, under the Americans with Disabilities Act, I designate Disability Services to be the holder of records documenting my disability and request for accommodations that are appropriate and reasonable in the academic and student services environment.

Submitting This Form
  1. A Thank You web page is displayed when your form is sent successfully. If you do not see a Thank You page, your form was not sent.
  2. You can expect an email confirmation from Disability Services within 1-2 business days.
  3. If you have any questions, comments, or problems with this form, call us at 281-283-2648.

State Law Notice

State law requires that you be informed of the following:
  1. With few exceptions, you are entitled on request to be informed about the information the University collects about you by use of this form.
  2. Under sections 552.021 and 552.023 of the Government Code, you are entitled to receive and review the information.
  3. Under section 559.004 of the Government Code, you are entitled to have the University correct information about you that is incorrect.

 Date Updated: 25-NOV-2015
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