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Section 504 Accommodation Plan Request
Request for accommodations under Section 504 of the Rehabilitation Act for a student with a disability that substantially limits a major life activity.
PDF TemplateUse the instructions below to complete this form
Instructions
Submit a written request to the school's 504 coordinator. Describe the student's disability and how it affects their ability to learn. Provide supporting medical documentation. The school must convene a 504 team to determine eligibility and develop an accommodation plan. Unlike an IEP, a 504 plan does not require specialized instruction but provides accommodations such as extended time, preferential seating, or modified assignments.