ADA Initial Contact Form

* indicates a required field

INSTRUCTIONS


This form may be used by: 

· Applicants for employment seeking hiring process or interview accommodations.

· Community members, including prospective students, requesting accommodations for attending events (such as ASL interpretation or CART transcription services), participating in activities, and requesting stadium seatback accommodations.

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

· Employees requesting workplace accommodations, submitting general questions, requesting event or activity accommodations, including ASL interpretation or CART transcription services.

· Individuals requesting digital accessibility reviews or consultation.

· Employees, guests, and visitors requesting Paratransit services.

 

This form should not be used by:

· College of LSA employees seeking workplace accommodations - contact LSA Disability Navigators

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

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

· Graduate student employees - contact Rackham Graduate School

· Students requesting Paratransit services - complete the SSD request form 



If you would like to Report a Barrier to access or Request ECRT Training, fill out our online contact form.

ADDITIONAL REQUESTS ACKNOWLEGMENT

Required

If you have previously submitted a request via this form, do not submit a secondary request here. Instead, log in to your Accommodate case file to submit an additional request. If you do not have a University of Michigan 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:

Upload supporting document(s)

UNIVERSITY INFORMATION:

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

OPTIONAL INFORMATION:

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

Are you interested in learning about upcoming events, workshops, or other information?

You may receive 1-2 emails per month with a list of upcoming events or a newsletter.