Immaculata Learning Support Services: COVID-19 Accommodations Request - Spring 2021
Immaculata University is committed to providing reasonable accommodations to individuals with increased risk for severe illness as outlined by the Centers for Disease Control and Prevention. Additionally, individuals may request a COVID-19 accommodation if they are the primary caretaker for someone that is considered high risk of life-threatening complications arising from COVID-19, or if a member of their household is considered high risk of life-threatening complications arising from COVID-19.

Request must be submitted by November 30, 2020.

Students seeking a COVID-19 accommodation for themselves must also complete this form as well as the COVID-19 Learning Accommodations Medical Request form (https://drive.google.com/file/d/1Jm3Amr7KQNbziLed4eXZciDkeWFp3i_q/).

Students seeking a COVID-19 accommodation as a caregiver/co-habitant must complete the form below, including caregiver/co-habitant section. You must also provide a physician/healthcare provider letter certifying the high risk of life-threatening complications arising from COVID-19 for caregiver/co-habitant to Learning Support Services at covidrequest@immaculata.edu.

Once your forms/documentation have been received, the Learning Support Services office will follow-up with you regarding next steps.

Please reach out to the Executive Director Learning Support Services at jperuso@immaculata.edu or 484-323-3900 with any questions.
Next
Never submit passwords through Google Forms.
This form was created inside of Immaculata. Report Abuse