Public Accommodation Request

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Student Information

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Please use your university issued email address

Specific Accommodation Information

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General Services RequestedRequired
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Is this request for accommodations due to temporary injuries or illnesses?Required
Are you requesting an ESA (emotional support animal)?
Documentation


Upload supporting document(s)

You may also mail, fax or email documentation to Accessibility Services, instead of uploading it to this form.

Center for Behavioral Health and Accessibility Services. One University Plaza, MS 8220. Cape Girardeau, MO 63701.

Fax: (573) 986-6031.   Email: cbha@semo.edu

The above form provides an overview to the Accessibility Services staff about services that may be appropriate. The final decision regarding services that are provided will be determined by the student's documentation and what is supported through that documentation along with information gathered during the interactive intake process. You will not be eligible to receive or use your accommodations until you have a meeting with Accessibility Services and complete the registration process.

Release of Accommodation InformationRequired

Please list additional people who are allowed access to pertinent information related to your academic progress. Examples include parents and other support people outside of the University. It is not necessary to include instructors or faculty members.

Upon successful submission of the form, you should receive a confirmation email once you have submitted your form. Please follow the directions detailed in the confirmation email. Submitting your registration does not automatically qualify you for accommodations. 

Requests submitted on the weekend or a holiday will be addressed when the office reopens.