Indicate any previous accommodations you have received and the corresponding dates
Nature of Disability
For each impairment, indicate the year of diagnosis in provided box
Indicate the specifice accomodation(s) you are requesting; accomodations must be applicable to the disability. (Requests will not be processed if no accomodations are requested below.)
Unacceptable Forms of Documentation
Please do not submit the following documents. ABO & NCLE will not accept them.
• Handwritten letters from licensed professionals
• Handwritten patient records or notes from patient charts
• Diagnoses on prescription pads
• Self-evaluations found on the internet or in any print publication
• Research articles
• Original evaluation documents; please submit copies of the original documents
• Previous correspondence from ABO & NCLE. We maintain copies of all correspondence.
• Correspondence from educational institutions or testing agencies not directly addressed to the ABO & NCLE
Current evaluation report (from within the past three years) from the appropriate health care professional.
Documentation of any previous accommodations provided by educational institutions or other testing agencies.
I, the undersigned, certify that the information I have provided is correct. I give permission to the Department of Testing Services to contact the licensed professional who diagnosed my disability and the educational institution that granted me previous testing accommodations for additional information for clarification as needed. I authorize such professionals and educational institutions to provide ABO-NCLE with such clarification and further information as needed.