Accommodations and Flexible Teaching Arrangement Request Forms

The following forms are for faculty to request accommodations or flexible teaching modality arrangements for spring, 2021 courses because the faculty member has a documented disability or is at high risk for COVID-19 that causes them concern about in-person teaching (accommodation), or lives with someone at high risk for COVID-19 (flexible teaching arrangement).

These forms are only for faculty who wish to dispute the teaching modality for one or more of the classes to which they are assigned in spring, 2021. It is not necessary to fill out these forms if the faculty member agrees with the mode of delivery of their assigned classes.

Accommodation for Faculty Member

This form should be used for a faculty member who has been assigned to but does not want to teach in-person classes in spring, 2021 because they are at high-risk for COVID-19 per the CDC guidelines or has other medical condition / disability for which the employee is seeking accommodation.

Flexible Teaching Arrangement

This form should be used for a faculty member who has been assigned to but does not want to teach in-person classes in spring, 2021 because they live with at least one individual considered at high-risk for COVID-19 per CDC guidelines. The form serves as a request for assistance from the Faculty Affairs team in the Provost's Office to work with you and your supervisor on finding a solution that might include a flexible work arrangement (online instruction) for the spring 2021 semester if you have been unsuccessful at resolving such a request with your supervisor.