Feedback for UMMC Academic Accommodations

* = Required Fields

Last Name*	*
First Name*	*
Middle Initial
Student ID#:*	*Invalid Number
School:*	School of Dentistry School of Graduate Studies School of Health Related Professions School of Medicine School of Nursing School of Pharmacy School of Population Health *
Program:*	*
Year (M1, D2, PT3)*	*
UMMC Email Address*	*Invalid Email
Gender* Male Female *
Race:*	American Indian or Alaska Native Asian Black or African American Caucasian Native Hawaiian or Other Pacific Islander Other *
Are you Spanish, Hispanic, or Latino?* Yes No *
Referral Source*	Brochure Employee Student/Health Faculty/Staff Office of Academic Support Orientation Peer Self Student Affairs Webpage Other *
Please rate the webpage for UMMC Academic Accommodations found on the Office for Student Success website:
Ease of Navigation?* Poor Fair Average Good Excellent *
Quality of Information?* Poor Fair Average Good Excellent *
Please rate the process for requesting academic accommodations at UMMC:
Timely?* Poor Fair Average Good Excellent *
Thorough?* Poor Fair Average Good Excellent *
Organized?* Poor Fair Average Good Excellent *
Reasonable?* Poor Fair Average Good Excellent *
Please provide comments about the process for requesting reasonable academic accommodations at UMMC: