Live Remote Proctoring (LRP) Accommodation Request Form
Applicants may request LRP accommodations for reasons such as distance from a testing site (over 40 miles), site closures, medical conditions, undue burden, or other circumstances as determined by CMCI. All requests must include clear, relevant supporting documentation (e.g., location details, medical letters, proof of closure, or a written explanation of hardship).Please note: Submission does not guarantee approval. Requests are reviewed case-by-case, and CMCI reserves the right to approve or deny at its sole discretion.
Date
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Month
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Day
Year
Date
Certification Program
*
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CACM
CCM
Name
*
First Name
Last Name
Email
*
LRP Request Reason
*
Please Select
Proximity to Testing Location
Illness
Undue burden
Testing site closures
Other
Details of Request
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Please give us as much information you can regarding the reasoning behind the request
Supporting documentation
*
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Please provide documentation that supports your request
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V1.0: 11282023
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