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

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. A functional limitation is defined as the behavioral manifestation of the disability that impedes the individual’s ability to function.

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.

Please review the information in each tab below, before considering an accommodations request.

The NBCE accommodations process will most likely be more stringent than any of your previous schools, as we provide high-stakes licensure exams for students coming from many different schools across the country, all with different standards and requirements for approvals.  The National Board is categorized under a different title of the ADA than educational institutions with different obligations, ultimately responsible for assisting state boards in protecting the public.

The majority of the time, an accommodations request is sent back to the examinee for more documentation, which can take several days or even months to obtain. It is recommended that a 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 extended time), in the majority of cases. Certain resource-intensive accommodations require expert ADA consultant approval, which may further delay the approval process.

Hopefully, you have a better understanding of the accommodations procedure.  Be sure to review each tab for for more detailed outlines of specific requests.





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 (CBT)




Begin your desired exam application in your mynbce account. Click “Awaiting Test Accommodations” and follow the prompts.
NOTE: Do NOT submit payment before the accommodations process is completed – payment will finalize your application. Accommodations cannot be added to an existing appointment, so you MUST follow these steps:

Step 1: Disability Category
Select category and provide your medical documentation, which can be uploaded from your device or by choosing from documents you may already have in your library. Essential information can be found in the Documentation tab on this webpage. Keep in mind that medical documentation is the absolute most critical information for your application.

Step 2: Accommodations Requested
Select the necessary ADA accommodations recommended by your medical provider from the drop down. The last option is ‘other’, which allows you to enter specific information. Additional information can be found in the Documentation tab on this webpage.

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. A substantiating document must be uploaded for each institution listed.

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 five 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: Accommodations Decision
If you are waiting for an accommodation request decision – Do NOT complete payment as this will finalize your application without accommodations.

Once a decision has been made, you will receive an email from support@nbce.org with instructions for finalizing your application, payment, and scheduling. In the case of a denial, the email may also outline additional documentation that may be submitted for a final review.

Step 7: Payment
Your application will be final once you have submitted payment. If accommodations have been approved, our system will alert us to obtain confirmation with Prometric to verify the correct accommodations have been added to your exam.

Step 8: Verification
Once approved accommodations have been verified with Prometric, you will receive an email notifying you to proceed with scheduling your exam. Please allow at least two business days after submitting your payment to receive this notification.

Step 9: Scheduling
You will schedule your exam in your MyNBCE account. Please note that scheduling must be completed by 5pm (Mountain Time) for any given deadline, as changes may not be made after official deadlines. For questions regarding scheduling availability, please contact accommodations@nbce.org.


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 in order to provide equal access to taking the exams. 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 functioning 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
    *NOTE: We require Clinical full-battery testing reports; Self-report versions of assessments are not accepted.
  • 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 ability to perform a major life function as defined by the ADA
  • On provider letterhead with provider credentials, license number, date, and signature

Must include current or most recent school accommodations approval and any other institution where accommodations were approved to establish history, including other standardized exams authorizations.

Personal Statement:

  • Explanation of how your impairment limits your functioning in regards to testing
  • Why the requested accommodations are necessary for board exams


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.

Nondiscrimination Notice

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.


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