Test Accommodations

Who Is Eligible To Receive Test Accommodations?

The NBCE seeks to ensure that our exams are fully accessible to all qualified examinees; therefore, we welcome applications for reasonable and appropriate accommodations on our exams in accordance with the Americans with Disabilities Act (ADA) and other federal guidance, provided such modifications do not result in a fundamental alteration to the examination, impose an undue burden, or jeopardize examination security.

An extensive guide for NBCE Test Accommodations follows (scroll down).  If you have any questions regarding test accommodations, please contact: accommodations@nbce.org


I Was Denied Test Accommodations. What Can I Do?

To appeal the NBCE’s decision, you may request reconsideration by e-mailing accommodations@nbce.org.  You must provide substantive supplemental documentation and clearly articulate the basis of the appeal, linking it to the documentation that supports your request.

If you are unable to meet the deadline:

  • You may schedule your exam without accommodations.
  • You may reschedule your exam for a future administration.

Comprehensive Guide To NBCE Accommodations

The ADA defines disability as a physical or mental impairment that substantially limits one or more major life activities as compared to most people in the general population. Accommodations should align with the identified functional limitation so that the adjustment to the testing procedure is applicable to the identified impairment.


Through an individualized assessment of the examinee’s functional limitations and exam-related barriers, the NBCE will determine what (if any), accommodations are appropriate for each of the NBCE examinations.

The NBCE provides high-stakes licensure exams, and is ultimately responsible for assisting state boards in protecting the public. Because of this, we are categorized under a different title of the ADA than educational institutions. The NBCE may require more supporting documentation, or not offer as many testing accommodations as you might have received at your chiropractic college. We will always engage in an individual assessment of your request, and utilize an interactive process to determine if the requested accommodation(s) are appropriate for the NBCE exams.

If we do need more documentation to evauate your request, it can take days, to several weeks to obtain the new documentation and resubmit a request. It is recommended that request for accommodation is submitted at least one month prior to your expected testing dates. Authorized accommodations carry over to all Part I, II, III, and Physiotherapy exams once you have been approved for one of them. State and Specialty exams require an accommodation request/approval for each exam, each time.

Part IV – Requires a different review, and additional documentation may be requested. Prior approvals for accommodation on computer-based exams may not be approved for those same accommodations for Part IV, as the practical, rotation format negates the need for common accommodations (such as reduced-distraction environment), in the majority of cases. Certain resource-intensive accommodations require expert ADA consultant approval, which may further delay the NBCE accommodations decision.






Accommodations must be approved BEFORE you register and schedule a test appointment; new or additional accommodations CANNOT be added to an existing test appointment. A scheduled appointment requires cancellation and an entirely new appointment application process started, with an accommodation request submitted and approved.

We advise individuals requesting accommodations to submit their request at least one month in advance of the desired test administration in order to allow time for necessary documents to be obtained, uploaded, and reviewed.  Approvals can not be guaranteed in time for deadline; we strongly recommend applying as early as possible for accommodations.



Process for Computer Based Tests




In your mynbce account, begin an application for the exam you want to schedule. Click “Awaiting Test Accommodations” and follow the prompts.

Step 1 (Disability Category): Select category and upload your medical documentation, which can be uploaded from your device or by choosing from documents you may already have in your library.

Step 2 (Accommodations Requested): Select specific accommodations recommended by your evaluator on the drop down. The last option is ‘other’, which allows you to enter specific information.

Step 3 (History of Accommodations): When prompted with “Chiropractic or Undergraduate Accommodations (and dates)”, explain when and where each specific accommodation was approved and used.

Step 4 (Personal Statement): Use the text box to write a short summary describing how your disability impairment substantially limits your current functioning and impairs your ability to take the NBCE computer-based exams under standardized conditions.

Step 5 (Affidavit): Agree to the accommodations affidavit and submit your request.

For all exams (with the exception of Part IV), your request will be reviewed within two business days, followed by a notification email of decision. This will be either an approval, a request for more information, or a denial, which will come with an explanation. Some requests require outside ADA expert review, which takes an additional 1-2 business weeks. You would then follow the instructions in the message.

Step 6 (Payment After Approval): Do NOT complete payment if you are waiting for an accommodation request approval!  This will complete your application, but there is one more step with accommodations…..

Step 7 (Submit Preferences): Submit date and location preferences. At this point, you will see what you submitted with no further action.

Step 8 (Scheduling): Once you press “Send Scheduling Request”, the accommodations specialist will be notified to request scheduling with Prometric, and your request will be placed on the scheduling que. This waiting period takes from a few days to a few weeks if a site needs to extend hours to accommodate. Your accommodations specialist will contact you if necessary to resolve any scheduling issues. Contact accommodations@nbce.org anytime to check the status of your request.

You will be notified of your scheduled appointment via Prometric email. At least a week prior to your exam, you will receive an email from accommodations@nbce.org with a document attachment with specific instructions regarding how your accommodations will be administered.

Process for Part IV

Accommodations approved for CBT exams do not guarantee accommodations for Part IV!  Many who qualify for accommodations for other exams do not qualify for the Part IV practical format. The Part IV exam design removes need for extended time accommodation in most cases.

Steps 1-7 are essentially the same as above. An important difference is that you may submit payment before your accommodations are approved, since the Part IV exam does not involve placement with Prometric. This allows you to receive your time-stamp toward securing your location preference(s). We recommend submitting your accommodations request at least one month before the exam deadline.

The Part IV format is a clinical, practical station-based exam. A new personal statement is required to explain how your impairment provides specific barriers to a clinical, practical exam format. Past documentation stored in your library may be used. However, documentation may need to be updated to provide evidence of current functional limitation.

Be sure to view the Part IV webpage and watch the corresponding videos to get a feel for this exam.

Supporting documentation is necessary to determine what (if any), accommodations are appropriate for a disabled individual in an examination setting and context. It is essential that supporting documentation provide a clear description of the functional impairment and rationale for the requested accommodation that is relevant to the specific examination.



Medical/Psychological Documentation



Your goal is to:

  • Provide detailed documentation from a qualified professional to substantiate all reported clinical diagnoses
  • Indicate how your disability meets full criteria for the reported diagnoses
  • Establish how and to what extent the diagnoses impair real world fuctioning in major life activities
  • Substantiate a credible rationale explaining the need for the requested accommodations in a national board testing environment

This can be demonstrated with a complete evaluation conducted by a health care professional appropriately qualified for evaluating the disability, which contains:

  • What diagnostic methods, tests, procedures, and/or assessments were used
  • Detailed test scores
  • Resulting diagnosis
  • Comprehensive interpretation of test results
  • History of disability
  • Specific recommended accommodations
  • Rationale for how accommodation(s) will reduce the impact of the identified functional limitation
  • Description of limitations due to the disability, as evidence of how the impairment substantially limits your abilty to perform a major life function as defined by the ADA
  • On provider letterhead with provider credentials, license number, date, and signature

Personal Statement:

  • Explanation of how your impairment limits your functioning in a major life activity
  • Why the requested accommodations are necessary for board exams

Approvals: Past accommodation approvals to establish history, including other standardized exams authorizations, but must include current or most recent school approval.


Personal Items



Examinees with ongoing medical needs may require specific devices during testing. While examinees do not need permission to utilize these devices, testing center staff will inspect the devices before examinees enter the secured testing area. These include medicines and medical devices, communication aids, and mobility devices.

NBCE Preapproved Personal Items

The items listed are permitted in the secure testing area, subject to inspection by test site staff. If you have a medical need for one or more of these items, you do not need to make a request or submit documentation to the NBCE for approval. You will show the item to test staff when you check in for your examination. Please note that all devices with external communication capability (i.e. cellular, wireless, Bluetooth, etc.) require preapproval. If you have a medical need for those items, please contact the NBCE at: accommodations@nbce.org.

Medicine and Medical Devices

                               A-E                         F-O                            P-Z
Arm Sling Glucose monitor Pills**
Bandages Glucose tablets Spinal cord stimulator
Braces (neck/back/wrist/leg/ankle) Hearing Aid Stool for elevating a limb
Cane Heart rate monitor Surgical face mask
Casts/cervical collar Ice packs TENS Units
Catheter Inhaler Urine drainage bag
Cochlear implant Insulin pump Vocal cord magnifiers
Colostomy bag Medical alert bracelet Walker
Cough drops (unwrap @ site, place in bag provided by NBCE) Medical device attached to body Walking boot cast
Continuous glucose monitor communication aids Mobility devices Wheelchair
Crutches Nitroglycerin tablets
Epi-Pen Non-electric heating pad
Eye drops Orthopedic support
Eyeglasses (without case) Other*
Eye patches Oxygen tank

*Other: Service animals trained to do work/perform tasks for a person with a disability

**Pills: Unwrap at test site and place in bag supplied by NBCE – You may bring pills in original packing only if manufacturer dictates they must remain packaged (such as nitroglycerin pills that cannot be exposed to air).

If you have a medical condition that requires use of an item NOT on the list, contact accommodations@nbce.org for additional information on how to request a personal item exception, or if your medical condition requires additional accommodation.

Examinees who have need for non-standard testing conditions should follow the guidance provided here, relative to need.


Test Conflict with Religious Observances (Religious Exemption)



If you are unable to schedule a Part IV exam or a computer-based test that avoids conflict with a religious observance, please go to the NBCE Process tab and complete these steps:

STEP 1 (Disability category): Select ‘other’ from the drop down, and type “Religious Observance”.  You will upload a document signed by your religious leader stating your need to be exempt from taking the exam on a certian day of the week and/or time of day.

STEP 2: Select the drop down option ‘other’ and type in your need, for example; “cannot test Saturday”.

STEP 3: Enter whether you received this courtesy in current and undergrad schools (skip document upload).

STEP 4: Use the text box to write a short summary explaining your need for the religious observance courtesy.

Follow the rest of the steps as stated for an accommodated examinee. Please note, there are limited seats available; the NBCE recommends submitting these requests at least one month prior to the deadline.


Nursing Mothers



Nursing mothers should notify registration staff when arriving at the test site. You may bring a breast pump and a small cooler (which will be inspected), and may access these items only during scheduled breaks and when sequestered during Part IV.

Nursing mothers who require additional break time for pumping must formally request accommodations, following the steps outlined on the NBCE Process page.





Information received in support of requested disability accommodations including the application, the personal statement, and accompanying documentation are securely stored on NBCE servers. Information will be shared with NBCE test accommodations personnel only for the purpose of determining eligibility for test accommodations. This includes any contracted content experts needed for a comprehensive review. Privacy and limits to sharing are subject to any legal requirements to provide information, or the sharing of information with attorneys and third parties in the event of any legal action taken against the NBCE as a result of an accommodation decision. General demographics and any identified categorical data will be used for research benchmarking purposes only.

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