Disability Services

Disability Services

Application for Services: Federal Law prohibits Viterbo University from making pre-admission inquiries about disabilities. It is prudent for students with disabilities to identify themselves in a timely manner. Information you provide is voluntary and is kept confidential. To faciliate your learning experience at Viterbo University, complete the following information and submit this form along with proper disability documentation to Jane Eddy, Disability Services Coordinator at 608-796-3194 or jleddy@viterbo.edu. You will have an opportunity below to attach digital forms when you submit this information.

1 Start 2 Complete

Read and sign below:

  • It is the student's responsibility to make a disability known and to provide proper documentation (including test results) from a licensed professional describing diagnosis, limitations, and recommended academic adjustments and/or auxiliary aids. Documentation should not be more than two years old.
  • It is the student's responsibility to request services in advance each semester.
  • The student understands that academic adjustments and/or auxiliary aids are not automatically granted.

My signature below certifies that the information provided is accurate and acknowledges that I am fully aware of my responsibilities as it relates to my request for services. Failure to follow these guidelines may result in a delay or interruption of services.

Files must be less than 2 MB.
Allowed file types: gif jpg png rtf pdf doc docx xls xlsx.