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Online Application

Important Messages

Please use your UA provided email.
Personal Information
  1. Note: Select when you would like to start your services.
  2. Hint: Enter 8 alpha numeric characters.
Contact Information
  1. Hint: Enter 10-digit number only.
  2. Hint: Enter 10-digit number only.


  1. Which campus / administrative unit are you affiliated with? *
  2. What's your affiliation? I'm a(n).... *
  3. Do you have a qualifying disability that limits a major life activity? *
  4. Does your qualifying disability impact your ability to perform the essential functions of your job? *
  5. Have you had accommodations for this same disability in the past? *

Terms and Conditions

By clicking submit, I agree to initiate and/or participate in the ADA Accommodation process electronically and I certify that I have read and agree with the following statements:

  • The statements, information, and documentation that I have provided either in this form or by any another submission means are complete, accurate, and true to the best of my knowledge. I understand that any information that is knowingly or intentionally false or misleading may result in employment action under applicable UA HR policies or procedures.
  • I believe I have a disability that may affect my work. I give the ADA Accessibility Team and/or any UA authorized ADA Accommodation reviewers (collectively the “Assigned Reviewer”) permission to evaluate and review my documentation, my workplace environment and job responsibilities, and any proposed reasonable accommodations under the American with Disabilities Act.
  • I understand that submitting this form is an initial step only, and that I will need to engage in an interactive process with the Assigned Reviewer.
  • I understand that the Assigned Reviewer must be able to confirm the existence and extent of my disability and how it affects my ability to perform the duties and responsibilities of my position. I understand that this may require me to provide medical documentation and/or authorize contact between my medical provider and the Assigned Reviewer.
  • I understand that if I am granted a reasonable accommodation, this may require disclosure of some information about my specific needs and/or the approved reasonable accommodation to supervisors and others at UA who have a business need to know in order to assist them in providing or implementing the approved accommodation.
  • I agree to actively participate in the ADA Accommodation process and to provide all necessary information to the Assigned Reviewer to facilitate the processing of my request.

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