Special Accommodations Form

To be completed by the Examinee (or Examinee’s Advocate) (This section must be completed)
I have submitted education, medical, and/or psychological records needed to justify approval of the testing accommodations for which I have applied. I understand that the document(s) will be reviewed by testing accommodations administrators. The records will be kept confidential. However, if an inquiry is made into the status of my application, I grant permission for ACBN to provide such status to individuals named in this or state department accommodations administrators, or the test center.
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