Request for Disability Accommodation

Missouri State University is committed to providing an accessible and supportive environment for employees and students with disabilities. Please tell us if you require a reasonable accommodation to perform your job. A request for accommodations will not be used against you in any way, and the information you provide will be safeguarded. All university employees have a legal obligation to maintain confidentiality regarding a staff or faculty member’s disability-related information. To that end, supervisors and representatives from the Office for Institutional Equity and Compliance shall provide information to staff and faculty only when necessary to facilitate accommodations.


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Personal information
Please tell us how you prefer to be contacted.
Please provide your phone number or "N/A" if not applicable.
Please provide your email address or "N/A" if not applicable.
Employee/Student Information
Please provide your BearPass # if you are an employee or student.
Please tell us your job title if you are an employee.
Please tell us which office or department you work for if you are an employee.
Please tells us the name of your supervisor if you are an employee.
Accommodation Information
Please be as specific as possible (e.g. adaptive equipment, reader, interpreter).

What accommodation(s) are you requesting?
Why are you requesting the specified accommodation(s)?