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Testing Accommodation Letter Template
A testing accommodation letter gives a testing body the diagnosis, what it limits during the exam, and the accommodations you recommend, each tied to a limit. Copy the template, see a type 1 diabetes and a Crohn’s disease example, and check what the main testing bodies ask for.
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- Word and text downloads
- Two filled examples
Blank testing accommodation letter template
FreeTESTING ACCOMMODATION LETTER [Practice name] [Address] [Phone and email] Date: [Date you sign the letter] To: [Testing body's accommodations or disability services office] Re: [Candidate's full name] Date of birth: [Date] Exam: [Exam name and format, e.g. computer-based, paper, or clinical stations] Test date or window: [Date or registration window, if known] Candidate ID: [The testing body's ID or request number, if any] [Candidate name] asked me for this letter to support an accommodation request, and agreed to the health information in it. [For a minor: their parent or guardian also agreed, following the law where you practise.] MY ROLE I am [candidate name]'s [treating physician, specialist, nurse practitioner, or psychologist]. I have known them in this role since [month and year]. Last examined: [Date, in person or by video, with where each of us was] DIAGNOSIS AND HISTORY Diagnosis: [The specific diagnosis, in definite terms] First diagnosed: [Month and year, and on what basis: examination, tests, or criteria] Course: [Permanent, long term, episodic with how often it flares, or temporary with an expected recovery date] Treatment: [Current treatment and medications, and any side effects that matter during a test] LIMITATIONS ON TEST DAY [What the condition limits during this exam, with how often and for how long, e.g. needs to check and treat low blood sugar, or urgent washroom visits several times an hour] Under standard conditions: [What would happen without accommodation] RECOMMENDED ACCOMMODATIONS 1. [Accommodation, with the exact amount: minutes of break, percent of extra time, or the item] Reason: [The limitation it addresses, and how] 2. [Accommodation, with the exact amount] Reason: [The limitation it addresses, and how] Not recommended: [Accommodations considered and not needed, e.g. extra time; otherwise delete this line] PAST ACCOMMODATIONS [Accommodations used at school, at work, or on earlier exams, with dates; or none, and why they are needed now] I examined [candidate name] myself and am not a family member. The testing body decides which accommodations to approve. For questions about this letter, call [practice phone]. [Your name, credentials, specialty] [License or registration number, and where you are licensed] [Signature]
Use it for
- College admission tests
- Law, medical, and graduate school admission tests
- Professional licensing exams
- Extra breaks or extra time
- Food, medication, and devices at the desk
Two filled examples. Every part, filled in.
Each one follows the template. Use them to judge how much detail every part needs.
Testing accommodation letter example: type 1 diabetes, SAT
Pediatric endocrinology clinic, routine visit; letter for the high school’s testing coordinator to submit
Candidate and consent
17-year-old high school junior registering for the SAT next spring. She and her mother asked for the letter at her visit, and both agreed to share the diagnosis with the testing body.
My role
I am her pediatric endocrinologist and have treated her since her diagnosis, at age 10, in June 2019. I examined her in person on Tuesday, October 13, 2026.
Diagnosis and history
Type 1 diabetes, diagnosed in June 2019 when she presented with diabetic ketoacidosis. Long term. She uses an insulin pump and a continuous glucose monitor with its own receiver. Over the past 3 months she has had 2 to 3 lows a week, most often in the late morning.
Limitations on test day
A low brings on shakiness, poor concentration, and slow reading. When her monitor alarms, she has to check her level, take fast-acting glucose, and wait about 15 minutes to recover before she can think clearly. A high makes her thirsty and sends her to the washroom more often. Under standard conditions, she would treat a low on test time, or keep working while impaired.
Recommended accommodations
1. Permission to keep her monitor receiver, glucose meter, pump, fast-acting glucose, snacks, and water at her desk, so she can treat a low as it starts. 2. Extra breaks with the clock stopped, up to 15 minutes each time her glucose is out of range, to treat it and recheck. Not recommended: extra time. With her supplies at hand and these breaks, her reading and reasoning are not affected while her glucose is in range.
Past accommodations and signature
Under her school’s diabetes care plan, she keeps her supplies with her in class and during tests and may step out to treat a low; she has never needed extra time. Signed by her endocrinologist on clinic letterhead, with her license number and where she is licensed, and dated October 13, 2026.
Testing accommodation letter example: Crohn’s disease, nursing licensure exam
Gastroenterology clinic, follow-up visit; letter plus the nursing regulator’s health professional form
Candidate and consent
26-year-old nursing graduate applying to write her licensure exam. She asked for the letter and agreed to share her diagnosis with the regulator. She plans to book her exam once the regulator decides on her request.
My role
I am her gastroenterologist. I diagnosed Crohn’s disease by colonoscopy and biopsy in March 2021, have treated her since, and examined her in person on Monday, October 19, 2026.
Diagnosis and history
Crohn’s disease of the terminal ileum and colon, long term. She has an infusion every 8 weeks, and her last flare was in May 2026; her medication has no side effects that affect testing. Even in remission, she has 3 to 5 urgent bowel movements a day, often with little warning, and cramps until she can go.
Limitations on test day
In a long timed exam, she can’t predict when she will need the washroom, and may need it more than once an hour, for 5 to 10 minutes each time. Holding on brings pain that breaks her concentration. Under standard conditions, every visit would come out of her test time.
Recommended accommodations
1. Unscheduled washroom breaks with the clock stopped, up to 10 minutes each, so a visit doesn’t cost her test time. 2. A seat by the door, in a room close to a washroom, so each trip is short. Not recommended: extra time. Her reading and reasoning are not affected, and the breaks meet the need.
Past accommodations and form
In her nursing program, from September 2022 to April 2026, she took washroom breaks without losing exam time and sat by the door. The regulator has its own form for the health professional; I gave the same answers on it and sent it to the regulator myself, as the form directs.
What testing bodies ask for. Checked October 2026.
Each testing body publishes its own rules for what an accommodation request must include, so these rows are examples from some of the main ones, taken from their own pages. A body that runs its exam in both countries, such as LSAC, applies one set of rules to every test taker. For any other exam, check that body’s accommodations page before you write.
United States: College Board (SAT, PSAT, AP)
Students with a physical or medical disability must request accommodations through College Board’s Services for Students with Disabilities even if they have an IEP or 504 plan, including permission to eat, take medication, test blood sugar, or use medical equipment during the test. Documentation should state the diagnosis, include the initial evaluation and an update generally within 12 months of the request, describe current symptoms and functional limitations, and justify each accommodation; a brief note from a doctor is usually insufficient. Students with a short-term injury or condition aren’t eligible through this process.
United States: ACT
A current, valid IEP or 504 plan that authorizes the same allowable accommodations is enough. Without one, ACT needs a letter or report from a licensed, qualified professional that identifies a professionally diagnosed physical or mental impairment substantially limiting one or more major life activities, and requests accommodations appropriate for it; complete diagnostic documentation may be required. An examinee with no history of using the accommodations also submits an Exceptions Statement Form explaining why they’re needed now.
United States: LSAC (LSAT)
New requests need the Candidate Form plus supporting documentation, such as records of past accommodations, LSAC’s Qualified Professional Form, or a signed letter on letterhead from a qualified professional. For candidates without a severe visual impairment, more than 50% extra time needs the professional’s rationale based on history and objective evidence, and asking for more time than the documentation supports can lead to a partial or full denial. Accommodations approved for a temporary condition, such as a broken bone, aren’t approved again automatically.
United States: USMLE
Examinees with medical conditions such as diabetes, and those who are breastfeeding, can request additional break time only. Pre-approved items, including glucose monitors, continuous glucose monitors, pills, and casts or slings, need no request, but using a personal phone as a glucose monitor receiver does. The program suggests requesting as early as possible and allowing about 60 business days for a decision.
United States: ETS (GRE, TOEFL, Praxis)
The professional should have personally examined the test taker, and a diagnosis from a family member isn’t accepted. Reports should be typed in English on letterhead, dated and signed, with the evaluator’s licensure and where they practice, and say whether the evaluation was in person or by telehealth. Each accommodation should be linked to a functional limitation; extra breaks for routines such as checking blood sugar may suit better than extended time, and snacks needed in the testing room require advance approval.
Canada: Medical Council of Canada (MCCQE, NAC, TDM)
The candidate sends a detailed letter or report, signed and dated on official letterhead, from a treating medical professional qualified to evaluate their functional limitations. It describes the limitations and needs for the exam’s format, since a computer-based exam and an OSCE can differ, and gives specific recommendations with reasons, such as the exact percentage of extra time or minutes of break. Documents more than 2 years old need a new letter confirming the limitations are still present, and approvals are valid for one exam only.
Ontario: College of Nurses of Ontario (registration exams)
A request must rest on a professionally recognized diagnosis, have a clear impact on writing the exam, and be current, and a new request is needed for each attempt. A health professional, such as a family doctor or psychologist, completes a Supporting Information form attesting to the nature and current status of the condition, and the candidate submits the request before booking the exam. CNO may use this information to decide whether the candidate has a condition that could affect their ability to practise nursing safely.
What goes in each part.
Exam and candidate
Which exam the letter is for, and who it’s about. Testing bodies weigh the limits against their own exam’s format.
- Your letterhead, and the date you sign
- The candidate’s full name and date of birth, as registered
- The exam’s name and format: computer-based, paper, or clinical stations
- The candidate’s ID or request number, if the testing body gave one
Avoid: One general letter for every exam. Limits on a 2-hour computer test and on a day of clinical stations aren’t the same.
Your role and consent
Who you are to the candidate, how long you’ve known them, and that they asked for the letter.
- Your role: treating physician, specialist, nurse practitioner, or psychologist
- How long you’ve known them, and in what capacity
- When you last examined them, and whether it was in person or by video
- For a minor, the parent’s or guardian’s consent, following the law where you practise
- An adult candidate consents for themselves; their parents see the letter only if they agree
Avoid: Writing for your own relative. Some testing bodies won’t accept a diagnosis from a family member, even one who is licensed.
Diagnosis and history
Unlike most letters, this one usually needs the diagnosis: testing bodies ask for the specific diagnosis, how and when it was made, and its course. Include it only with consent.
- The diagnosis in definite terms, not “may have” or “consistent with”
- When it was first diagnosed, and on what basis
- Whether it is permanent, long term, episodic, or temporary, with a recovery date
- Current treatment, and any medication side effects that matter during a test
Avoid: Every diagnosis in the chart. Give only the ones behind this request.
Limitations on test day
What the condition stops the candidate doing, or slows, during a long timed exam. Testing bodies decide on current limitations, not the diagnosis alone.
- What happens in the exam room: lows to treat, urgent washroom visits, pain, or fatigue
- How often and for how long, in numbers
- How the candidate is now, with treatment
- What would happen under standard conditions
Avoid: “Would benefit from extra time.” Say what the limit is, and how it shows up in a test.
Recommended accommodations
Each accommodation, with its exact amount, and the limitation it answers. The testing body decides what to approve.
- Exact amounts: minutes of break, or the percentage of extra time
- One reason for each, tied to a limitation above
- Breaks rather than extra time, when the need is a medical routine
- Items to keep at the desk, such as food, a glucose meter, or a pump, when the body needs a request for them
Avoid: Asking for more than the limit justifies. A request the documentation doesn’t support can be cut back or denied.
Past accommodations
What the candidate has used before, at school, at work, or on other exams. Testing bodies weigh this history.
- Each accommodation, where it was used, and when
- Whether it helped
- If there is no history, why accommodations are needed now
Avoid: Leaving it blank. If the condition is new, say when it started.
Signature and credentials
Your details, so the testing body can see that you’re qualified to evaluate the condition.
- Your name, credentials, and specialty
- Your license or registration number, and where you’re licensed
- Your signature and the date, on letterhead
- A phone number for questions
Avoid: A handwritten line on a prescription pad. Testing bodies expect a typed, signed, and dated letter, or their own form.
Common mistakes, and how to avoid them.
A diagnosis without limits
Testing bodies decide on what the condition limits now, in a timed exam, not on the diagnosis alone. Describe what happens in the exam room, and how often.
More than the limit justifies
Ask only for what the limitation needs. When the need is checking blood sugar or reaching a washroom, breaks often fit better than extra time, and an unsupported request can be cut back or denied.
Out-of-date documentation
Each testing body sets how old a letter or evaluation can be, and some want an update within the past year. Check its guidelines, and write from a recent visit.
A short note instead of their guidelines
A 2-line note is rarely enough. Most testing bodies publish documentation guidelines, and some have a form for you to complete. Follow them.
Requesting what’s already allowed
Some exams allow medication, glucose monitors, casts, and similar items without a request; others want a request even for these, and food at the desk or a device that connects to a phone often needs approval. Check the body’s list before you add them.
Leaving it late
Reviews can take weeks or months, and some deadlines are firm. Write the letter as soon as the candidate decides to apply, and return any form promptly.
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Frequently asked questions.
What should a testing accommodation letter include?
Your role and how long you’ve known the candidate, the specific diagnosis and when and how it was made, what the condition limits during a timed exam, and each accommodation with its amount and the reason for it. Add past accommodations, and sign it on letterhead with your credentials and license or registration number.
Does a testing accommodation letter need the diagnosis?
Usually, yes. Unlike an employer, most testing bodies ask for the specific diagnosis and how it was made. Include it only with the candidate’s consent, or for a minor, the parent’s or guardian’s, following the law where you practise.
How do I write a letter for extra time on an exam?
Describe the limitation that slows the candidate down, with the evidence for it, and give the exact amount, such as 50% more time, and why that amount. Larger amounts need stronger evidence. If the need is a medical routine, such as checking blood sugar, recommend breaks instead.
How recent does the documentation need to be?
It depends on the testing body and the condition. Some want an update within a year for a medical condition; others accept older documents with a new letter confirming the limits are still there. For a permanent condition, a short statement that its impact hasn’t changed may be enough.
Does a school accommodation plan carry over to standardized tests?
Not automatically. Some testing bodies accept a current school plan with the same accommodations; others review every request, including permission for food or medication in the room. Check the body’s rules before the student registers.
What about a broken arm or another temporary condition?
Testing bodies handle these differently. Some suggest rescheduling until it heals, some allow a cast or sling without a request, and an approval for a temporary condition may not carry over to the next sitting. Say in the letter that it is temporary, and when you expect recovery.
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How early should the candidate apply?
As early as they can. Reviews can take weeks or months, some testing bodies don’t consider late requests, and some want the request decided before the candidate books a seat.
Who can write a testing accommodation letter?
A licensed professional qualified to diagnose the condition, who has examined the candidate: often the treating physician, specialist, nurse practitioner, or psychologist. Some testing bodies won’t accept documentation from a family member. Learning disorders and ADHD usually need a full psychoeducational or neuropsychological evaluation, not a letter alone.
Is this testing accommodation letter template free?
Yes. Copy it, or download it as a Word or text file. No account needed.
Can Vero write a testing accommodation letter from my visit?
Yes. Paste this template into Vero, and it drafts the letter from your visit, with the limits on test day and the reason for each accommodation. Review and edit it, then export it to PDF or Word, or copy the answers onto the testing body’s form.
More templates, and guides.
Doctor’s note template
For work or school: the visit, the dates off, the return, and any limits.
Return-to-work note template
To an employer: full or modified duties, the restrictions, how long they last, and the review date.
Medical leave letter template
To an employer or leave administrator: when the leave starts, how long it lasts, the review date, and what the return needs.
Workplace accommodation letter template
To an employer: what the condition limits, the change that would help, how long, and answers to the employer’s questions.
Pregnancy accommodation letter template
To an employer: the pregnancy-related limitation, the change needed at work, and how long it lasts.
College accommodation letter
Ongoing accommodations through a college or university’s disability office.
School accommodation letter
Supports in class and on school tests for a K–12 student.
Missed exam note
When illness kept a student from an exam on the day.
Vero Documents
Fill a testing body’s or regulator’s PDF form from the visit and the chart.
Your template. Filled in from the visit.
Vero writes your notes and letters in the templates you choose, so you review instead of type.
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