Disability Support Resources
Test Accommodation Form
Grand Valley State University
: It is Student YOUR RESPONSIBILITY to work with your professor, complete this form, and submit it AT LEAST ONE WEEK BEFORE the scheduled time of your exam. This timeframe is necessary so arrangements can be made for testing rooms and proctors. Use this form only if you are requesting testing accommodations through Disability Support Resources. If your instructor provides testing accommodations, you need to use this form. (Please review your syllabi and discuss dates and times for ALL of your exams for the semester with your Instructor.) do not
This form must be completely filled in.
If you are using an email account other than your GVSU student email, please add email@example.com to your email address book to prevent email from this system from being filtered by spam filters.
Please include the following information
* Denotes A Required Field
First Name: *
Last Name: *
G Number: * (GXXXXXXXX)
Daytime Phone: * (xxx-xxx-xxxx)
Email Address: *
Professor Name: *
Professor Email: *
Confirm Professor Email: *
Course Number and Section: * (eg. ANT 220-01)
Day(s)/Time Class Meets: * (eg. M-W-F 6:00-8:00 pm or T-Th 8:00-10:00 am)
Number of Exams *
Date and Time of Exam 1: *
Testing Accommodation I am requesting: *
To schedule a test, submit test accommodation forms to Testing Services online seven days prior to
the test date. PEW Campus requests may be made by noting "PEW" under the "other" accommodation
choice. A hard copy alternative form is required if the seven day deadline for the online testing form has
been missed. The alternative form can only be obtained from the Testing Coordinator.
Note: If two alternative forms are used during one semester, you may lose testing privileges until you meet with your DSR
Testing appointments begin and end at the scheduled time. Arrive at least 5 minutes prior to the test time.
If an individual arrives late then the testing time will be reduced. When the scheduled test time ends all
testing materials, including the completed test and scantron (if applicable) will be collected promptly.
For example, if you are scheduled to test from 9:00-11:00 and arrive at 10:00, you will have only 1 hour to test and all testing
materials must be turned in at that time.
Requests for FINAL EXAM accommodations must be submitted online 14 days prior to the test
date. Arrive no less than 10 minutes prior to the scheduled test time. Alternative forms will not be
accepted for final exams.
Final Exams must be scheduled in one of the following time slots: 8:00 a.m., 11:00 a.m., 2:00 p.m. and 5:00 p.m.
DSR will not reschedule you for a "missed" test without notification/approval from the professor.
The professor is not required to allow you to makeup or reschedule a "missed" test.
Note: If two "missed" tests occur in one semester, testing privileges may be suspended until you meet with your DSR Advisor.
The following items are prohibited in the testing room: cell phones, purses, book bags, coats, hats and/or
Exceptions will be made for religious attire if requested.
Food is not allowed in the testing area. If a documented medical condition exists which requires food,
then it may be consumed outside of the testing area. Please notify the testing staff if accommodations are
Drinks are allowed.
Staff may not clarify questions on tests.
Do not leave the testing area without permission. If you need to use the rest room or need testing
supplies please notify the testing staff.
Any form of academic dishonesty will forfeit testing accommodations with DSR for the remainder of
By checking the box below and clicking "Submit", I verify that I am a DSR program participant and am listed to receive the test accommodations checked above.
Note: Student must bring all materials necessary for the exam as allowed by the instructor. (See initialed items below.)
NOTE: You and your instructor should agree upon the date and/or time of your exams to be taken through DSR.
Your instructor must approve any subsequent changes. The DSR Office is open for testing Monday through Thursday,
8 am to 9 pm, and on Friday 8 am to 5 pm. All exams must be scheduled and completed during these hours. You may not
stop working on your exam and return at a later time and/or day to complete the remaining unfinished exam without your
instructor's written approval. Arrive at the DSR Office at the scheduled time of your exam. We may not be able to
accommodate you if you arrive late.