Short-Term Medical Accommodations Request

Contact us 

Michael Cruce, PhD.
Director of Student Accessibility Services
(402) 465-2149
mcruce [at] 91ciba.com (mcruce[at]nebrwesleyan[dot]edu)

For our accommodation appeal procedure, email mcruce [at] 91ciba.com (Michael Cruce).

Short-Term Medical Accommodations Request

For current students who are experiencing a short-term medical condition, surgery, or medical recovery and request temporary accommodations please complete this Short-Term Medical Accommodations Form. Accessibility Services will reach out to you to set up an intake interview to set up time limited accommodations.

Student
(Optional)
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Phone
(Optional)
(Optional)
Injury/Illness/Condition
(Example: Sept. 1- September 15). This should also be outlined in documentation by your medical provider. 
Schedule