Housing Accommodatio by HC120616184448


									             Disability Services Concordia University- St Paul
                 Housing Accommodation Request Form
Concordia University-St. Paul is a liberal arts college. Learning to live cooperatively is an
integral part of the University’s mission to “prepare students for thoughtful and informed living”.
Living with others, learning to share space, working out issues with sleeping or living habits is
part of the cooperative campus experience.

Concordia is also committed to providing equal access in housing for students with disabilities
who have proof that a disability substantially limits a major life activity and significantly
affects housing arrangements. Students are responsible to provide this information to Disability
Services by stated deadlines. Residence Life staff members and Disability Services will then
review all requests, determine any possible configurations and alternatives. Final decisions are
based on: availability of suitable rooms, severity of disabilities, lack of other effective
accommodation options, potential impact on a roommate, and finally, any undue hardship.

Please also note that the availability of single rooms is extremely limited and granted infrequently
as an accommodation. We will first attempt to find someone with similar functional limitations
prior to granting single room as an accommodation.

Please Complete This Information and Return To Disability Services by the Due Date Listed on
the Housing Website:

Name: __________________________________________________________________
Class Year: (Freshman, etc.): ______________________________Date:____________
Request: ________________________________________________________________
Reason for Request: _______________________________________________________
Alternative Options: _______________________________________________________
Information Required with Housing Request:

    1. A letter from your physician, psychologist or other professional health care
       provider stating why this accommodation is required and how the request will
       ameliorate the impact of diagnosed disability.
            Include diagnosis and treatment plan
            A description of the necessary housing configuration
            Possible alternatives that would be effective as an alternate
            Credentials of the person providing the diagnosis. (This cannot come
               from the parent or student, must be provided with contact information and
               be typed on letter head and signed. In addition, the professional must have
               some kind of medical certification. In general, information from
               Chiropractors is not acceptable as documentation.)

This information should be forwarded by the due date to:
Disability Services                            Confidential Fax: (651) 603-6222
275 Syndicate St North                         For information call: (651) 641-8272
St Paul, MN 55104-5494

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