WGU Forms

Western Governors University would like to provide our students with disabilities the appropriate and reasonable accommodations they need to fulfill all requirements of their degree/certification program. Please complete and submit the form below to begin the process for accommodation. If you have already completed this form, please do not submit a new form. Contact Student Disability Services (sds@wgu.edu) to have your request reopened. If you have questions or need assistance completing this form, please contact Student Disability Services at sds@wgu.edu or 877.435.7948 x5922.

Information contained on this form will be kept confidential and will only be revealed by WGU to those individuals who have a need to know (for example to assist in providing you with an accommodation) or if otherwise required by law. Your accommodation request will be reviewed only when the necessary medical documentation is submitted.

Please take a moment to view Policies and Procedures for Students with Disabilities.

First Name*

Last Name*

Student ID

Enrollment Stage

Daytime Phone*

Evening Phone

Primary Email*

Alternate Email

Time Zone

Best Time To Contact

List all diagnoses and/or medical conditions for which you are seeking accommodations.*

Indicate how this condition(s) impacts you academically.*

List the accommodations requested and indicate how the accommodation is necessary due to your diagnosis.*

Please indicate your current operating system software type (Mac/Windows/Linux/Other) and version, if known.

Please list any and all assistive software (including version, if known), tools, and/or aids that you currently use as a result of your disability.