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Only Housing Accommodations Application

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This form is for students who have a disability, defined as "a physical or mental impairment that substantially limits one or more major life activities". You must provide documentation of necessity from a medical or mental health provider licensed and in good standing in the state of Texas. The provider must have personally evaluated the student's disability or mental health condition and have an established clinical relationship with the student.

Scope of Accommodations:
Disability Services does not process requests for larger bed sizes (e.g., Full/Queen upgrades) or standard roommate requests.

  • Beds: If your documented disability requires university-provided furniture to be removed so you can bring your own approved personal medical bed, you may use this form provided you have disability/medical documentation sufficiently indicating the need.
  • Roommates: Roommate-specific accommodations are only considered if the requested individual is your documented Personal Care Attendant (PCA).
  • For standard roommate requests or housing assignments, please contact Islander Housing directly.


Please allow 2-3 weeks for review and processing. If you are requesting an ESA (Emotional Support Animal), do not bring your animal onto campus until final approval is received by Islander Housing.

You must already have completed an Islander Housing Application before submitting a housing accommodation request. Please use this form to submit your disability housing accommodation request.
Personal Information
  1. Note: Select when you would like to start your services.
  2. Note: Select when you plan to graduate.
  7. Hint: Enter 9 alpha numeric characters.
  8. Hint: Enter date in the following format Month/Day/Year (i.e. 12/31/2010).
Contact Information
  1. Hint: Enter 10-digit number only.
  2. Hint: Enter 10-digit number only.
Local Address
  4. Hint: Enter zipcode as 97331 or 97331-0000.
Permanent Address
  4. Hint: Enter zipcode as 97331 or 97331-0000.
Additional Information

Questions

  1.  
    Have you already applied for Islander Housing and paid your application fee? (If not, please do so before submitting this form.) * (Selection is Required)
  2.  
    I am a * (Selection is Required)
  3.  
    Are you a PSA student? * (Selection is Required)
  7.  
    I understand that I need to resubmit documentation and my housing accommodation request each year it is needed.. * (Selection is Required)
  8.  
    I understand that providing fake or fraudulent documentation for my housing accommodation request is prohibited. Such actions may lead to an incomplete application and disciplinary action per the Student Code of Conduct. * (Selection is Required)
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