This website uses scripting to enhance your browsing experience.
Enable JavaScript
in your browser and then reload this website.
This website uses resources that are being blocked by your network. Contact your network administrator for more information.
Disability Services Application
Loading...
Please Read Completely
In order to receive academic accommodations during your attendance at New Mexico Highlands University you must supply appropriate clinical documentation of your disability. In evaluating your documentation, Highlands has adopted standards utilized by Association of Higher Education and Disability (AHEAD) member institutions. Failure to supply appropriate medical documentation will result in your application for services be denied. Please note that high school IEP’s alone are never sufficient to document a disability.
All students must submit the attached Medical Certification form, completed by an appropriate and qualified health care services provider.
For students with
Learning Disabilities
, the Medical Certification form must be accompanied by a full diagnostic evaluation completed by a licensed neuro-psychologist or psychologist trained in the assessment of learning disabilities. This evaluation must have occurred within the last three years and must clearly state that (a) a learning disability exists. (b) the nature of the learning disability, (c) the test utilized to diagnosis the learning disability and (d) accommodations required.
For students with
psychological, emotional, and psychiatric disabilities
, the Medical Certification form must be accompanied by an evaluation by a licensed psychologist or psychiatrist based on the current DSM manual. The evaluation must have occurred within the last year and clearly indicate (a) the DSM code for disability (b) the severity and length of the disability, (c) the current course of the treatment, (d) any medication prescribed, and (e) accommodations required.
For students with
physical disabilities
, a diagnosis from the current ICD from a physician is required. For students with
audio disabilities
, this form must be accompanied by a current audiogram from an ENT or Audiologist.
Before completing this form, please answer the following question:
Do you have a digital/electronic copy of your documented disability from a healthcare provider as described above?
no
yes
Prior to completing this form, please acquire documentation of your disability from a healthcare provider by providing the linked form below to your provider and then uploading a digital/electronic copy to this application.
Disability Documentation Form
Healthcare Provider Documentation
Please upload your documentation here:
Application for Accommodations
In order to begin the process to receive accommodations based on a disability each student must submit the following paperwork (Additional paperwork may be required):
This form completed and submitted.
A signed and dated copy of the Release and Medical Information form.
Documentation of disability consistent with the requirements outlined in the attached handout entitled “Disability Documentation Requirements.”
I am requesting accommodations at New Mexico Highlands University because I have a disability as defined by the Americans with Disabilities Act (ADA) and/or Section 504 of the Vocational Rehabilitation Act and/or the ADA Amendment Act of 2008.
I understand that it is my responsibility to follow the procedures of ACCESS and supply all the necessary paperwork to document the presence of my disability.
I understand that professors are not required to supply accommodations retroactively.
I understand it is my responsibility to notify ACCESS prior to the beginning of each semester that accommodations will be needed and I will provide all necessary course information, including instructor(s) full names.
I understand that no accommodations will be made until all documentations have been received by ACCESS and instructors have been notified of approved accommodations.
Accommodations Student In-Take Form
Today's Date
Today's Date
January
February
March
April
May
June
July
August
September
October
November
December
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
2020
2021
2022
Banner ID/Student ID
Please identify your student level
Graduate
Undergraduate
Birthday
Birthday
January
February
March
April
May
June
July
August
September
October
November
December
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
1919
1918
1917
1916
1915
1914
1913
1912
1911
1910
1909
1908
1907
1906
1905
1904
1903
1902
1901
1900
First Name
Last Name
NMHU Student Email
Phone Number
Address
Address
Country
Street
City
Region
Postal Code
Sex
Female
Male
Non-binary
Other
If you would like the opportunity, we invite you to share more about your gender identity.
I am requesting accommodations at New Mexico Highlands University because I believe that I have a disability, as defined by the Americans with Disabilities Act (ADA) and/or Section 504 of the Vocational Rehabilitation Act and/or the ADA Amendments Act of 2008. By signing this form I am aware of the following policy and procedures of NMHU and that these must be followed for me to receive an accommodation.
No accommodations will be provided until I have turned in all necessary documentation and all instructors have been notified.
The
Documentation of Disability Form
must be filled out completely before any accommodations can be made. Similar documentation from healthcare providers may also be acceptable.
I acknowledge that additional documentation may be required on a case-by-case basis in order for ACCESS to appropriately evaluate my request for accommodations. I agree to provide this documentation in a timely manner. I further understand that NMHU may require that I be examined by a health services provider of its choice, at its expense, before providing the accommodation.
I understand that, if I have a disability I must be otherwise qualified to participate as a student at NMHU, as those terms are defined under the ADA and/or Section 504 of the Vocational Rehabilitation Act and/or the ADA Amendment Act of 2008. NMHU is required to provide me with a reasonable accommodation of my disability, but not necessarily the accommodation that I request. These accommodations will be determined by an interactive process with the coordinator of disability services.
I need to submit a class schedule that includes course name and number, CRN number, and full name of instructor before the University’s add/drop deadline for each semester. All instructors must be notified of accommodations on a timely basis.
All my information be treated confidentially by the university. I am responsible for informing my professors of the accommodation approved for me if I want the professors to be aware of it. ACCESS will not automatically do so on my behalf.
If I have any disagreement with a decision by ACCESS, I can appeal that decision to the VP of Academic Affairs.
Submit