ADA Initial Contact Form

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INSTRUCTIONS FOR THE FORM BELOW

University of Michigan employees with Single Sign On (SSO) access should submit initial and additional requests by logging in to Accommodate. Do not use the form below.

Employees (Ann Arbor campus staff and faculty, Dearborn staff and faculty, Michigan Medicine faculty, and Graduate and Undergraduate Student Employees) can use Accommodate to submit requests for workplace accommodations, including parking and Paratransit; answers to general questions, including digital accessibility review or consultations; American Sign Language (ASL) interpretation or Communication Access Realtime Translation (CART) services.

 

The following groups may use the form below for their first request: 

-Applicants for employment requesting hiring process or interview accommodations.

-Community members and visitors to campus, including prospective students, requesting: answers to general questions; ASL interpretation or CART services to attend an event; stadium seatback accommodations; Paratransit services on campus

-Students seeking appeals for Housing or SSD decisions (select General Question/Consultation under Reason for Contact).

To submit additional requests, the above groups will need to email DisabilityEquity@umich.edu.

 

The form should not be used by:

-Michigan Medicine staff (excluding faculty) seeking workplace accommodations - contact the HR Solutions Center

-Undergraduate or Graduate Students seeking academic or event accommodations - contact Services for Students with Disabilities

-Students requesting Paratransit services - complete the SSD request form

-Employees seeking temporary accommodations (less than six months) - contact Work Connections

 

If you want to report a barrier to access or request training from the Disability Equity Office, fill out our online contact form.

You can find helpful information on various accessibility and disability-related topics on our Presentations & Trainings webpage.

ADDITIONAL REQUESTS ACKNOWLEDGMENTRequired

If you have previously submitted a request via this form, do not submit additional requests using the form below. U-M employees can log in to their Accommodate case file to submit an additional request. If you do not have a U-M login, please email our team at DisabilityEquity@umich.edu and we will assist you with submitting your additional request.

I have not previously submitted information to the Disability Equity Office via this form.

DEMOGRAPHIC INFORMATION:

This section should be the information of the individual filling out this form. This may not be the person the request is for or who the question is regarding.

How you would like to be addressed by the Disability Equity Office staff

This is how the Disability Equity Office will contact you. If you do not have a university email, please enter your personal email address.

REQUEST INFORMATION:

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UNIVERSITY INFORMATION:

OPTIONAL INFORMATION:

The following questions are for data gathering purposes only, but may be helpful in determining future supports at U-M.

Information about your request may be shared with other university partners on a need to know basis. Required
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