Accommodation Request Name* First Last Email* Please describe the reason you are requesting an accommodation, including the specific underlying medical condition:*Please describe the accommodation(s) requested:*The library will make every effort to provide reasonable accommodation as requested. In some cases, however, a specific accommodation may not be provided reasonably. In the event that this occurs, please describe any other accommodations that would work for you:Digital Signature* By checking this box, you are agreeing to this digital signature request.Date MM slash DD slash YYYY
