Accessibility Services for Students with Disabilities New Student Accessibility Application Returning Student Accommodations Request Short-Term Medical Accommodations Request ESA Policy Accessibility by Building Menu Contact us Michael Cruce, PhD.Director of Student Accessibility Services(402) 465-2149mcruce [at] nebrwesleyan.edu (mcruce[at]nebrwesleyan[dot]edu)For our accommodation appeal procedure, email mcruce [at] nebrwesleyan.edu (Michael Cruce). Short-Term Medical Accommodations Request For current students who are experiencing a short-term medical condition, surgery, or medical recovery and request temporary accommodations please complete this Short-Term Medical Accommodations Form. Accessibility Services will reach out to you to set up an intake interview to set up time limited accommodations. Student Name Student ID (Optional) Address (Optional) City (Optional) State (Optional) - None -AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Zip (Optional) Phone Type (Optional) - Type -HomeCell Phone Email Advisor (Optional) I am a - Select -Incoming new studentFirst year studentSophomoreJuniorSeniorGraduate student Injury/Illness/Condition What is the estimated date or timeline of your injury/illness/condition? (Example: Sept. 1- September 15). This should also be outlined in documentation by your medical provider. Please state how your injury/illness/condition will impact your ability to participate on campus, in classes, or at other events at º¬Ð߲ݴ«Ã½. Schedule Current class schedule Submit Leave this field blank
