Student Disability Resources

Exam Accommodation Request Form

The Exam Accommodation Center (located in the Hixson-Lied Student Success Center) exists to help Professor/Instructors and TA's provide reasonable accommodations for students with documented disabilities. Typically, exam accommodations are coordinated and directed by the Professor, Instructor, and/or TA--professors/instructors are to make advanced arrangements utilizing their own departmental facilities/offices/staff to arrange and deliver exam accommodations. In many instances, the designated Departmental Disability Liaison can also be of assistance.

However, when Professors/Instructors are unable to provide the indicated exam accommodations (per the SAAR form), Student Disability Resources staff may be able to assist in administering the exam at the Hixson-Lied Student Success Center. To schedule an exam with SDR, Instructors/Professors must complete the form below and submit it at least one week in advance so timely arrangements can be made. You will receive an email regarding "next steps" as this form is provided. Testing hours are 8 a.m. - 5 p.m., Monday through Friday.

PLEASE NOTE: All EXAMS for this term may be scheduled using this form. Exam dates/times and pertinent detail/instructions must be provided (see below).

Student Information (from SAAR form)
Student Name
Student ID
DR Staff




Exam Accommodations approved by SDR (as indicated on SAAR)
1.5 Extended Time
2 Extended Time
Low Distraction Room
Private (Proctored) Room
Calculator
Reader/Taped Exam
Scribe/Dictated Exam
Speller's Dictionary
Word Processor
Increased Font
Font Size
Other Accommodations
Instructor Information
Instructor Name
Instructor Phone
Instructor Email
TA Or Dept Contact Name
TA Or Dept Contact Email
Exam Information
Course Name
Date Exam 1 Should Be Administered
Date For Exam 2
Date For Exam 3
Date For Exam 4
Final Exam Date
Time Exam 1 Should Be Administered
Time For Exam 2
Time For Exam 3
Time For Exam 4
Final Exam Time
How many minutes does the rest of the class have for the regular exam?
How many minutes does the rest of the class have for the final exam?
Student Should Use
Blue Book
Plain Paper
Scantron
Word Processor
Write Answers Directly On the Exam
Additional Exam Resources Allowed
NONE
Simple Calculator
Scientific Calculator
Dictionary
Note Cards
Notes
Articles/Readings
Tables
Formulas
Textbook
Course Packet
Scratch Paper
Other
How will the exam be DELIVERED to Exam Accommodations?
(1200K Hixson-Lied Student Success Center)
WebCT
WebCT Password
Email
   Email to examaccommodations@iastate.edu
Fax
   Fax to 294-6813
Hand Delivered By Instructor Or TA
Via Student In Sealed Signed Envelope
Campus Mail (please mail at least 3 days prior to exam to ensure receipt of exam)
   Mail to Exam Accommodations - Student Disability Resources, 1200K Hixson-Lied Student Success Center.
How will the Instructor RECEIVE the completed exam?
WebCT
Email To
Fax To
Hold Exam In 1200K Hixson-Lied Student Success Center For Pickup
Via Student In Sealed Envelope
Mail To