Office of Accessible Education
Exam Accommodation Request Form

Please submit this request at least one week ahead of the exam date.

Please make sure you have given your professor an Accommodation Letter and discussed the details of your exam.

* indicates required fields.

Name *

First

Last

Stanford Email Address *

Last 3 digits of your SUID Number *

Phone *

Disability Adviser (DA) or Learning Specialist (LS) *

Have you received an Accommodation Letter - for this quarter - from your DA or LS? *

Yes

If yes, have you given a copy of that Accommodation Letter to your professor? *

Yes

Exam Details

Please provide the following information for the class in which you are requesting exam accommodations.

Class (e.g. Bio 41) *

Date of Exam *

Start time of Exam *

Duration of the exam (WITHOUT Extended Time) *

Accommodation Details

Please provide the following information for the accommodations you are requesting.

I am requesting the following accommodations: *

Use of a computer

Use of assistive technology (in addition to/other than a computer)

Live reader

Live scribe

Exam in alternative format

Alternative testing site (Please note: students whose only exam accommodation is extended time do not need to complete this form. Instead, make arrangements directly with the professor to take the exam close to the standard location.)

Other (Please describe below in "Additional Information")

User Agreement

Please read the OAE Exam Accommodation Services User Agreement.

Do you agree to the terms as described in the OAE Exam Accommodation Services User Agreement?
Yes, I agree.

Additional Information

The Accommodations Coordinator will respond to your request directly.

Please skip. Do not fill this out.

Office of Accessible EducationExam Accommodation Request Form

Exam Details

Accommodation Details

User Agreement

Office of Accessible Education
Exam Accommodation Request Form