University of Wyoming Disability Support Services

Housing Access Application

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Housing Access Application

Introduction

Type: Housing & Dining Accommodaiton Application.

Please complete this application if you’re requesting any accommodations related to University of Wyoming housing or dining as well as emotional support animals. This includes an exemption from living on campus due to a medical related condition. Applications for housing accommodations and exemptions can be submitted at anytime; however, housing space can be limited and students should complete this process as early as possible. Some approved student requests may have a waiting period until the accommodation can be provided.
Documentation will be required to process your application.

Application Information

Start Termrequired field:

Personal Information

First Namerequired field:

Preferred Name:

Middle Name:

Last Namerequired field:

School IDrequired field:

Hint: Please include W with ID (ex. W12345678)

Gender:

Pronoun:

Contact Information

Email Addressrequired field:

Primary Phone Numberrequired field:Specify country code for Primary Phone NumberSpecify Primary Phone Number

List of Questions

Question 1: This form is for Housing and Dining Accommodation and Exemption requests due to a disability related need. If you wish to also explore academic or other campus accommodations, please visit our website for our accommodations application, more information, and our AIM registration link.
This form does not substitute for the Housing Application. Housing and Dining Accommodations will be considered with a signed active Housing Contract. Applications for housing accommodations and exemptions can be submitted at anytime; however, housing space can be limited and students should complete this process as early as possible. Some approved student requests may have a waiting period until the accommodation can be provided.

Question 2: By submitting this application, please understand that your application and documentation may be shared with need-to-know stakeholders in order to determine your eligibility for and/or implementation of your accommodation(s).
The following steps are included in our process:
• Application completed and submitted
• Medical Documentation submitted or attached to your application
• Completion of the Housing Contract (inquire with housing@uwyo.edu)
• Once DSS receives the information above, we may request that you meet with a DSS staff member to review your application and documentation.
• Based on the information provided in your application, DSS may request additional documentation. Documentation must be submitted by a qualified healthcare provider who knows you and your needs. It should be on their letterhead, signed by the provider who sees you for your condition.
• A decision will be sent in writing, typically via email. DSS staff may request follow-up communication and/or documentation if more information is needed to make a decision.
• If a student with a disability believes they have experienced discrimination from a member of the University of Wyoming faculty, staff, or administration solely on the basis of disability, in

Question 3: Please indicate which type of student best describes you:required field

I’m an incoming student who has not previously lived on-campus at UW

I live on campus but do not have housing/dining accommodations

I live on campus and have DSS housing/dining accommodations. I am requesting to renew these same accommodations.

I live on campus and have DSS housing/dining accommodations. I am requesting to change my accommodations.

Additional note or comment (Additional Comment Required)

Additional Comment:

Question 4: For which semester(s) are you requesting housing accommodations:required field

Current semester

Next semester

Duration of my time at UW

Question 5: Do you have a physical or mental condition that meets the legal definition of disability: "An individual with a mental or physical impairment that substantially limits one or more major life activities. Major life activities include (but are not limited to) caring for oneself, performing manual tasks, seeing, hearing, eating, sleeping, walking, standing, lifting, bending, speaking, breathing, learning, reading, concentrating, thinking, communicating, and working." (ADA)required field

Yes – Please describe your disability (Additional Comment Required)

I’m not sure (Additional Comment Required)

Additional Comment:

Question 6: What type of accommodation are you requesting?required field

Housing

Dining

Emotional Support Animal (ESA)

Other (Additional Comment Required)

Additional Comment:

Question 7: What specific accommodation(s) in University Housing are you requesting? required field

Question 8: Please describe the disability-related barriers you experience in the housing and/or dining environment.

In what way(s) do you expect your requested accommodation(s) to alleviate these barriers?required field

Question 9: Unless your disability is visible or apparent, you will need to provide documentation from a healthcare professional verifying the disability and necessity of the accommodation. Please select the best description of your supporting documentation.required field

My disability is visible/apparent. I would like DSS to verify if additional documentation is needed.

DSS has documentation supporting this request for housing/meal plan accommodation request.

I will upload relevant and/or new documentation as part of this application process.

I need to obtain relevant documentation from a provider and will upload it later or email it do udss@uwyo.edu.

Other (Additional Comment Required)

Additional Comment:

Question 10: Is there any other information that would be helpful for us to know?required field

Yes (Additional Comment Required)

Additional Comment:

Form Submission

I understand that I must provide documentation from my medical provider for my application to be processed and that if my requests are approved, there may be additional requirements to complete through Housing and Dining services.

Question?

Disability Support Services
University of Wyoming
Dept. 3135, 1000 E. University Ave.
Laramie, WY 82071
109 Knight Hall

Phone: 307 766-3073
Fax: 307 766-3298
Email: udss@uwyo.edu