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Student Pregnancy/Pregnancy Related Conditions Assistance Request Form
Submitting this form allows Title IX to coordinate with other university offices to facilitate options for reasonable adjustments and assistance related to student pregnancy/pregnancy related conditions status.
Reasonable adjustment options will be specific to what the student has disclosed to Title IX at the time of this application. Students who experience a variation in their condition or needs, should in addition to speaking to their faculty, inform the Title IX Office as soon as practicable to submit any amended request for needs so the Title IX Office can determine what if any additional assistance is necessary.
Disclosure of pregnancy/pregnancy related condition status is voluntary and not required, and students are not required to work with Title IX and may instead opt to work directly with their faculty to discuss absences, reasonable adjustments, and options for making up missed work.
The Title IX Office reserves the right to request additional documentation, if the information and documentation submitted with this form appears outdated, is completed by an inappropriate clinician, inadequate in scope or content, does not address or substantiate the student’s needs, or is unclear.
Submission of this form in no way implies that the requests contained in this form will be approved as submitted.
Students who experience a temporary or permanent medical conditions or disability arising from or exacerbated by pregnancy or pregnancy related conditions and/or complications and therefore may have needs that may be more appropriately considered through exploration of
with the Office of Disability Services (ODS) are responsible for initiating contact directly with ODS.
Reasonable adjustments that would fundamentally alter the academic objectives of a course or program or that would cause an undue hardship on the university may not be granted.
Students are required to fulfill the essential elements of each course, and once notification is sent, to speak directly with their faculty to work through any logistics.
To proceed, you must enter your initials as verification that you have read and understand the information on this screen.
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