This information requested below and any documentation regarding your disability and your need for accommodations in testing will be considered strictly confidential and will not be shared with any outside source without your express written permission.

Accommodations requested for NATE Certification Testing:

PLEASE CHECK ALL THAT APPLY:

Accessible Exam Site
Braille
Large Print
Tape
Reader (choose one)
for visual impairment
for learning disability
Scribe (choose one)
for visual impairment
for learning disability
Extended Time
Separate Testing Area
Other Accommodations (specify)

I understand that I must forward all required paperwork with this document at least 45 days prior to my exam
date in order to be processed.

I confirm that the details I entered are correct

NATE DOCUMENTATION OF DISABILITY RELATED NEEDS

If you have a learning disability, a psychological disability, or other disability that requires an accommodation in testing, please have this form completed by an appropriate licensed professional (psychologist, physician, or surgeon) to certify that your disabling condition that requires the requested exam accommodation. If you have existing documentation of having the same or similar accommodation provided to you in another test administration you may submit such documentation instead of having this form completed.


If you have existing documentation of having the same or similar accommodation provided to you in another test administration you may submit such documentation instead of having this form completed.