Because of recent legislative mandates, students with disabilities have unprecedented opportunities to attend institutions of higher education. Access to instruction and assessment is provided through the use of reasonable accommodations. However, such accommodations are legally and procedurally complex. This article addresses the legal and procedural evidence required to receive testing accommodations. In addition, we discuss procedures for supporting student needs by applying the principles of universal design to assessments. By changing assessment practices to include support structures for all students, access to higher education can be promoted.