Temporary Medical Accommodation Request Form

Temporary Medical Accommodation Request Form

In the spirit of Jacksonville University’s mission and values, the institution will review and consider student requests for special accommodations made in light of the COVID-19 pandemic. A few important notes:

- This request form is for medical-related accommodation requests, and supportive medical documentation must accompany your request. This supportive documentation should be a letter from your medical provider (on their letterhead) that establishes the need and the reason for the requested accommodations. The documentation should also detail any pertinent or requested accommodation that could/would provide you the necessary support.
- This request form is for accommodations related to a medical need for the semester.
- Please include any and all information related to your request.
- If the requested accommodation is approved, it will be approved for one semester only.