Students with Disabilities Accommodation Request

An accommodation request should be submitted and approved before the student starts work on each course. While accommodation requests are usually processed within two weeks, some may take longer. For more information, please see BYU Independent Study’s Accessibility and Accommodations Policy. Please email any questions to byuceaccommodations@byu.edu.

Please complete and submit this form along with supporting documentation of disability from a qualified healthcare professional. If the student attends secondary school, the student’s school counselor or parent/guardian should submit the student’s IEP or 504 Accommodations Plan. Requests for accommodations must be specific. Submitted documentation must be dated within the last three years.

Student Information

(i.e. MATH 101)

School Information

Parent/Guardian Information

Details of the Request

Files must be less than 5 MB.
Allowed file types: jpg jpeg png pdf doc docx.
Files must be less than 5 MB.
Allowed file types: jpg jpeg png pdf doc docx.
Files must be less than 5 MB.
Allowed file types: jpg jpeg png pdf doc docx.

Submit any additional supporting documentation by email to byuceaccommodations@byu.edu or mail to: BYU Independent Study, Attn: Accommodations, 317 HCEB, Provo, UT 84602

By typing or signing my name below, I attest that all information on this form is accurate to the best of my knowledge.

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