Pregnancy Accommodation Request Form

Title IX of the Education Amendments of 1972 is a federal civil rights law that prohibits educational institutions from discrimination on the basis of sex, including pregnancy and parenting status. Missouri State University takes all concerns of discrimination and harassment seriously. Pregnant women must be treated the same as other students with temporary medical conditions that require treatment. Title IX prohibits pregnancy discrimination in higher education with respect to admissions, hiring, leave policies, coursework accommodations and degree completion. If you need an accommodation because you are pregnant, please complete the form below.

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Missouri State University campus location

Requesting accommodation for

Title

First name

Middle name

Last name

Street address

City

State

Zip code

Phone number

Email address

Preferred method of contact

Anticipated due date

Additional information