Test Information and Adjustment Form
Please complete all the information below to schedule your test or quiz in the Office of Disability Services.
Your information must be ACCURATE since this form will generate an email to your instructor.
Call 372-6119 with any questions.
Student First Name
Student Last Name
Student Phone Number
Full Student Email
Full Instructor Email
Include course name and number
Date of Classroom Exam
Time of Classrom Exam including AM or PM
(e.g. 10:00 AM)
Testing Date in the Office of Disability Services
Must be the same date as the classroom test date.
Testing Start Time in the Office of Disability Services
Please enter a time between 8:00 AM and 11:00 AM OR between 1:00 PM and 3:30 PM.
Time given for test in minutes in the regular classroom
(Enter only a number, like 55 or 80)
Accomodations approved by ODS for your test or quiz:
Check all that apply.
I understand that if I submit a request after business hours or on weekends it will be received and processed at open of the next business day.
By clicking the button below you agree that the time for which I have signed up to take this exam does not conflict with any of your other courses.