ADA Requests

ADA accommodations should be requested at least 72 hours prior to registration. All medical information is completely confidential. Medical verification for ADA accommodations is only required the first time you submit an ADA accommodations request. The medical verification can be sent by email or fax.

Emailed medical verification should be sent to Faxed medical verification should be sent to (512) 349-6194 and marked “Attention ADA Request”. Questions and/or concerns can be emailed to

Please fill out the form below completely so that the requested ADA accommodations can be evaluated for you to attend one of The National Alliance’s classroom based programs or enroll in one of our online programs.

Request for ADA Accommodations (Fillable PDF)
(Print and fax or email form to:


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The National Alliance for Insurance Education & Research
P. O. Box 27027
Austin, Texas 78755-2027
Phone: 512-345-7932


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