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Accommodation Request Form 

Make sure all sections are complete before submitting the form. Paradigm accommodations specialists will review your documentation and let you know if any additional information is required.

Enter the access code that was given to you when you received confirmation of your request:

 

Access Code:_______________________       Date:___________________________

 

 

SECTION 1: REQUESTING TEST ACCOMMODATIONS: TO BE COMPLETED BY CANDIDATE

Part 1. Please indicate the testing accommodation(s) you are requesting:

_______• Extended Time: Standard Time + 25% (total: XX hours)

_______• Extended Time: Standard Time + 50% (total: XX hours)

_______• Additional 10-minute break per testing hour

_______• Scribe*

_______• Reader*

_______• Private room

_______• Other (specify):

*Note: These accommodations are automatically approved with a private room to prevent distractions to other test-takers. Please note that a scribe and/or reader are only approved in circumstances where the applicant is unable to read or write independently, even with extra time.

Part 2. Rationale. Provide a specific rationale for each accommodation you are requesting. You may also write a personal statement and attach that to your request.

Accommodation requested: ________________________________________________________________________________________

Rationale: ________________________________________________________________________________________

Accommodation requested: ________________________________________________________________________________________

Rationale: ________________________________________________________________________________________

Accommodation requested: ________________________________________________________________________________________

Rationale: ________________________________________________________________________________________

Accommodation requested: ________________________________________________________________________________________

Rationale: ________________________________________________________________________________________

 

Part 3. Currency: The evaluation must be completed by a qualified professional within the specific timeframe as specified below:
  • Physical Disabilities & Chronic Health Conditions:
    • No more than 1 Year prior to the anticipated date of the exam
  • Psychological & Psychiatric Disorders:
    • No more than 1 Year prior to the anticipated date of the exam
  • Attention-Deficit/Hyperactivity Disorder:
    • No more than 3 Years prior to the anticipated date of the exam
  • Learning and Other Cognitive Disorders:
    • No more than 5 Years prior to the anticipated date of the exam

 

Submit your Request for Test Accommodations

The most secure method for providing us with your confidential accommodations request materials is to upload your materials directly to Paradigm Testing’s secure SFTP Web site:

Accommodations decisions will be communicated to you within 30 days.