Testing Form

In order to accommodate students and faculty for Make-up Exams and Disability Services,
we have created an online form that will route directly to our office once it has been completed. Please complete this 48 hours prior to the test date.

Student Name:

Make-Up Exam
Disability Service Exam

Please mark all that applies to your student needs

Date of the exam:
Exam Start Time:
End Time:
Instructor's Name:
Instructor's Contact Number:
Instructor's Email:
Class Number:

Check all items students are allowed to use. If items are not listed please use the other box to list them.
	Calculator Book(s) Pen/Pencil Scrap Paper (Testing Center does not provide this) Notes Laptop/Computer Nursing Calculator
Other:

What are the special accommodations the disability services student needs?	Scribe Additional Time Quiet Room
If yes, let the student know they will need to notify Disability Services to set up these services. List special instructions you would like to give the proctor.
Comment:
Scheduling:	Student will be calling to schedule exam Exam has been scheduled

After Exams:

Exams will be picked-up by Instructor. Exam will be sent through campus mail to room