Counseling, Testing, and Health Services

Disability Accommodation Request Form

Student Responsibilities

Students desiring accommodations for a disabling condition are responsible for providing acceptable documentation to the Director of Counseling, Testing & Health Services. Acceptable documentation must have been produced by a licensed professional qualified to make the respective diagnosis and must usually be dated within the last three years. Any documentation submitted to the University for consideration must be provided in a timely manner prior to the period of stated need.

Student Information

Completion of this on-line form is required. You may also fill out the form at the Counseling, Testing & Health Services office which is located in the Mabee Student Success Center, 3rd floor.
Providing this information will help UMHB in offering effective, reasonable accommodations in a timely manner to assist you as a student.

(example: Fall 2017)

Please briefly state the nature of your disability/condition, requested accommodations, and other helpful information.

Official documentation must be no older than 3 years. Diagnosis and documentation must be accomplished by a licensed professional qualified to make the respective diagnosis.
(Maximum size of 5000 KB)

Official documentation must be no older than 3 years. Diagnosis and documentation must be accomplished by a licensed professional qualified to make the respective diagnosis. (Maximum size of 5000 KB)

Official documentation must be no older than 3 years. Diagnosis and documentation must be accomplished by a licensed professional qualified to make the respective diagnosis. (Maximum size of 5000 KB)