NCLEX Accommodations

NCLEX testing accommodations are approved through the board of nursing where you are applying for a license — not by Pearson VUE, not by the test center, and not by writing to NCSBN directly. This page covers candidates applying for a U.S. RN or LPN/LVN license, and it treats the NCLEX-RN and NCLEX-PN together, because the request process is the same for both.

The order that matters

1. Ask your board of nursing for its accommodation requirements and forms. (NCSBN calls each board a nursing regulatory body, or NRB.)
2. Send the request in with your license application. NCSBN's instruction is to do this before you register for the NCLEX with Pearson. Follow your board's specific paperwork sequence: Kentucky's form, for example, places the documentation upload after Pearson registration. Registration is not the same as booking an appointment.
3. Wait for written confirmation and for an Authorization to Test (ATT) email that lists your accommodations.
4. Then book your appointment. NCSBN request instructions; Candidate Bulletin, p. 7; Kentucky form, p. 1.

Do not book before step 3. The test center cannot add an accommodation on the day. You also cannot hand an approved accommodation back at the door — the Candidate Bulletin says candidates with accommodations cannot cancel them at the appointment. And ATT dates cannot be extended for any reason. Candidate Bulletin, pp. 7–8.

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NCLEX accommodations you can request

These are options published on the NCLEX accommodation request forms and policies of the Arizona, Indiana and Kentucky boards of nursing. Wording and available options vary from board to board, so treat this as a menu to ask about, not a list of things you are entitled to. Your own board's instructions control the request, and your board decides what it will support. Arizona policy, pp. 2–3; Indiana Form C, p. 2; Kentucky form, p. 3.

The hour totals below assume the standard five-hour limit, which applies to both the NCLEX-RN and the NCLEX-PN. Kentucky's form still prints an older four-hour PN reference; use the current Candidate Bulletin's five-hour baseline instead. The detailed extra-time and break arrangements below come from Arizona's policy and, where listed, Indiana's form; confirm your own approved arrangement before booking. Online booking is allowed only when one of the four qualifying time additions is your only approved accommodation. Candidate Bulletin, pp. 3 and 7; Arizona policy, p. 3; Indiana Form C, p. 2.

That last column comes from the Candidate Bulletin, and it matters more than it looks. Four time additions — extra time of 30 minutes, 1 hour, 2 hours or 3 hours — let you book your appointment online the normal way, but only if one of those is your only approved accommodation. Everything else means phoning Pearson NCLEX Candidate Services at the number on your ATT and asking for the NCLEX Accommodations Coordinator. Candidate Bulletin, p. 7.

Things you do not need to request

Check the comfort-aid rules before filing a full accommodation request for an item. Some items are already allowed when Pearson's conditions are met. Pearson Comfort Aid List.

Comfort aids

Pearson VUE publishes a list of items that need no pre-approval when the listed conditions are met. Test center staff visually inspect them, generally without touching them or asking you to remove them. Eyeglasses are an exception: you must remove them for visual inspection. The list covers:

• Medicine and medical devices: auto-injectors such as an EpiPen, bandages, neck/back/wrist/leg/ankle braces, casts and slings, cough drops, eye drops, eye patches, eyeglasses, glucose tablets, hearing aids and cochlear implants, inhalers, medical alert bracelets, nasal drops and spray, a pillow or cushion, an oxygen tank, pills, and a medical foot stool.
• Body-attached medical devices that make no sound: continuous glucose monitors, insulin pumps, spinal cord stimulators, TENS units.
• Mobility devices: canes, crutches, walkers, wheelchairs, motorised scooters and chairs.
• Other items: a handheld non-electronic magnifying glass without its case, a face mask and gloves, and — at Pearson Professional Centers, which is where the NCLEX is given — earplugs, noise-reducing headphones and tissues supplied by the center. Pearson Comfort Aid List; NCSBN testing-location guidance.

The conditions attached to that list matter more than the list itself:

• Pills, cough drops and glucose tablets must be unwrapped and out of any bottle or container. Pearson permits pills to remain packaged when the packaging says they must stay that way, such as nitroglycerin; the packaging must be inspected. The glucose-tablet allowance does not include hard candy.
• Devices in Pearson's body-attached category, such as an insulin pump or continuous glucose monitor, must be attached to your body and silent. If a device in that category makes noise, that needs an accommodation.
• You may not plug anything into the testing computer.
• An external remote control does need an accommodation. That includes a phone that controls your pump. A pump meeting the attached-and-silent conditions is allowed; the handset that runs it is not, unless it's approved ahead of time.
• An oxygen tank has to be self-contained and silent. If it needs power or makes noise, that needs an accommodation.
• A medical foot stool must be non-skid and metal-based, and Pearson also specifies a size limit. Check the current list and confirm the measurements with Pearson before bringing one. Pearson Comfort Aid List.

Standard-issue things people request anyway

A noteboard and marker. Every candidate gets an erasable noteboard and a marker, and you can raise your hand during the exam and ask for a clean one. No request needed. Personal scratch paper is prohibited, and the NCLEX is not given in a paper-and-pencil format. Candidate Bulletin, pp. 3 and 16; Minnesota guidance, p. 2.

Earplugs. Available from the test administrator if you ask. You may not bring your own. Candidate Bulletin, p. 16.

Unscheduled breaks. You can raise your hand to request a break whenever you need one; wait for the test administrator to escort you out. Minnesota's board guidance confirms candidates may take as many unscheduled breaks as they need. Candidate Bulletin, p. 16; Minnesota guidance, p. 2.

But here's the part that changes the answer: under the standard NCLEX rules, every break counts against your five hours, scheduled or not. Do not assume an unscheduled break stops the clock. If disability-related breaks would reduce the time you need to answer questions, describe that need to your board and ask how the approved arrangement will handle breaks and testing time. Extra time is one possible adjustment, not a substitute for an individualized request. Candidate Bulletin, p. 18; Pearson's individualized-accommodation guidance.

Food, drink, and speaking aloud

Food and drink. They are not allowed in the testing room under the standard rules. They go in your locker and you get to them on breaks. If you medically need food or drink at your desk, request an accommodation through your board. Minnesota's guidance specifies a separate room and supporting documentation for that arrangement; do not assume another board uses the same paperwork. Candidate Bulletin, p. 18; Minnesota guidance, p. 2.

Talking out loud. A separate room alone is not permission to talk through questions aloud. Minnesota's board states this directly. If reading questions aloud is how you work, a reader accommodation is a different arrangement, and it is not the same thing. Approved reader, recorder and interpreter arrangements have their own communication rules; a recorder, for example, enters answers you dictate. Minnesota guidance, p. 2; Indiana Form C, p. 2.

Documentation to check with your board

The paperwork must explain the disability-related need and support the accommodation requested. There is no single national document package. The published instructions checked for this guide — Arizona, Indiana, Kansas, Kentucky and Minnesota — differ in the evidence, forms and timing they ask for. NCSBN request instructions; Arizona policy; Indiana packet, p. 1; Kansas instructions; Kentucky form, p. 1; Minnesota guidance, p. 1.

Use the four categories below to check your board's requirements, not as four documents every candidate must obtain. Documentation must be tailored to the disability and the request; DOJ's guidance explains that one or two supporting documents may be enough in an individual case.

1. Your own signed letter or request form. Name every accommodation you want, specifically. Include your phone and email, because testing staff may need to reach you directly about arrangements. Indiana's Form C asks for this information and permits a signed letter instead. Indiana Form C, p. 1.

2. Documentation from a qualified professional. Where your board requests a report or letter, check its requirements for letterhead, a date, a signature and the professional's credentials. The requested information can include:

• A professionally recognised diagnosis. Minnesota asks for an official diagnostic code; Indiana asks for a DSM code when applicable. DSM is the Diagnostic and Statistical Manual of Mental Disorders; ICD is the International Classification of Diseases. A mental-health coding requirement does not mean every disability needs a psychiatric diagnosis.
• A history of the condition, any accommodations you have had before, and how it affects your day-to-day functioning.
• The relevant assessments and results, where needed for the request. Kansas names tests such as the Woodcock-Johnson and the Wechsler Adult Intelligence Scale as examples. That does not make those tests a requirement for every candidate or every condition.
• A recommendation for each accommodation, with a reason for why it addresses the documented limitation. Indiana packet, pp. 3–4; Kansas instructions; Minnesota guidance, p. 1.

That last bullet matters. Minnesota's guidance says the board grants a specific accommodation only if the provider recommended that specific accommodation. For example, a letter that recommends only extended time does not document a request for a separate room. Show your provider the options above and your board's instructions before they write the letter. Minnesota guidance, p. 1.

3. Your nursing-school accommodation history. Kansas, Kentucky and Minnesota ask for information from the nursing program or disability-services office. Indiana accepts its nursing-program Form B or a signed letter. If you did not have accommodations in your program, Minnesota asks for a short explanation; Indiana's Form B lets the applicant indicate that none were provided. Do not assume a lack of school accommodations makes you ineligible. Kansas instructions; Kentucky form, p. 1; Minnesota guidance, p. 1; Indiana packet, pp. 1 and 5; DOJ guidance.

4. Your board's own forms or accepted alternatives. Indiana provides Form A for the professional, Form B for the nursing program and Form C for the applicant, but accepts the required information in signed letters instead. Use the route your board actually permits. Indiana packet, p. 1.

How recent does the documentation have to be?

There is no national answer. Here is what the inspected board documents publish; these are selected examples, not a 50-state rule or a conclusion that every applicant needs a new evaluation.

A two-to-five-year spread across the four published windows above. Check yours before you pay for a new evaluation you might not need — or assume an old one will pass. Read these board instructions alongside the documentation protections below.

Do nursing school accommodations carry over?

Not automatically through the NCLEX registration system. You still have to request NCLEX accommodations through your board. But that does not mean your previous accommodation records can be disregarded or that you always need a new clinical evaluation. NCSBN request instructions; DOJ guidance.

Your school history still matters. U.S. ADA protections cover licensing examinations. The private-testing-entity rule in 28 CFR § 36.309(b)(1)(iv)–(vi) says documentation requests must be reasonable and limited to the need, prior accommodations must receive considerable weight, and responses must be timely. It specifically mentions an Individualized Education Program (IEP) and a Section 504 Plan. DOJ's guidance also addresses public testing entities. Federal rule; DOJ guidance.

DOJ explains that proof of prior accommodations in similar testing situations is generally sufficient. For the same accommodations documented in the most recent IEP or Section 504 Plan, proof plus certification of continuing disability-related need should generally be enough without further documentation. Not having prior accommodations does not by itself disqualify a candidate. Submit the records you have and ask what additional evidence is needed, and why, before paying for a new evaluation. DOJ guidance: documentation and past accommodations.

If your request is based on anxiety

A diagnosed anxiety disorder can support a request; ordinary test nerves alone do not establish a disability-related need. Minnesota's guidance distinguishes anxiety and test anxiety as symptoms from a diagnosed disorder and asks for a recognised diagnosis and code, the functional impact and a specific accommodation recommendation. Those are Minnesota's published documentation instructions, not a promise of approval for everyone with that diagnosis. Minnesota guidance, pp. 1–2.

So the question is not simply whether the NCLEX makes you anxious. The request needs to explain the condition's effect on testing and why the adjustment is needed. A qualified professional's individualized evidence matters; a diagnosis does not map automatically to a particular amount of extra time or a separate room. DOJ guidance; Indiana provider form.

One related point, since it comes up alongside this: English as a second language alone is not a disability and is not a basis for a disability accommodation under Minnesota's published guidance. A candidate who speaks English as a second language can still have a separate disability-related need. Minnesota guidance, p. 2.

How early to start

Start when you start your license application — not when you start thinking about a test date.

The clocks you're working against

• Your NCLEX registration stays open for 365 days, starting when your board receives the registration from the test service, while your board decides whether you're eligible.
• Once your board declares you eligible, your ATT arrives. It's valid for a period your board sets, averaging 90 days.
• ATT dates cannot be extended for any reason. Miss the window and you re-register and pay the fee again. Candidate Bulletin, pp. 6 and 8.

Start the accommodation process early, but an ATT already being issued does not prevent a request. NCSBN has a specific process for adding or changing accommodations after an ATT: contact your board, and follow its instructions about an updated ATT and any existing appointment. Do not assume the accommodation request extends your ATT dates. NCSBN change instructions; Candidate Bulletin, p. 8.

The part you can't control: how your board decides

The Candidate Bulletin gives no national turnaround time. It just says send the request as early as possible. Board instructions show why you need to check your own route rather than plan around a nationwide estimate: Candidate Bulletin, p. 7.

• Arizona reviews at staff level — the Executive Director or a designee. Arizona policy, p. 2.
• Minnesota says it emails instructions about the necessary documentation within 1–2 business days after an application requesting accommodations is submitted. That is an initial response, not an accommodation-approval turnaround. Minnesota guidance, p. 1.
• Kansas ties its published submission instructions to Board meetings held quarterly — March, June, September and December — and asks for requests at least 30 days before a meeting. Check the actual meeting calendar, not just the month. Kansas accommodation instructions.

Under Kansas's published quarterly schedule, a request arriving in early January would be planned around the March meeting, subject to the submission deadline and the board's instructions. That is a planning example, not an approval-date promise. Kansas accommodation instructions.

Find out how your board handles review before choosing a test date. Ask whether staff can decide your request or it needs a board meeting.

What the review actually checks

Arizona publishes its criteria. Staff check that the documentation is complete, that the documentation supports the accommodation requested, and that the accommodation is reasonable, can actually be delivered by NCSBN and Pearson VUE, and does not compromise the intent of the exam. A paper-and-pencil NCLEX is not an available exam format. Arizona policy, p. 2; Candidate Bulletin, p. 3.

The board's review can also involve NCSBN. Arizona's policy states that while the Board may recommend an accommodation, NCSBN reviews requests and grants or denies them. Indiana's form says the Board must submit documentation to NCSBN. Those descriptions of behind-the-scenes coordination do not change where you apply: the Candidate Bulletin requires your NRB's authorization, and your request goes through that NRB. Whatever is granted then shows up on your ATT. Arizona policy, p. 2; Indiana Form C, p. 1; Candidate Bulletin, p. 7.

A note on sequence

NCSBN tells you to request accommodations before registering with Pearson. Kentucky's form has you complete the board application, register and pay Pearson, and then upload the ADA documentation. Indiana asks for the request at the start of the application process but needs Pearson registration and payment before forwarding documentation to NCSBN. NCSBN request instructions; Kentucky form, p. 1; Indiana packet, p. 1.

Follow your own board's order for the paperwork. The current national booking rule is the same: don't book an appointment until you have written confirmation and an ATT that lists the accommodations. Candidate Bulletin, p. 7.

After approval: booking and changing your appointment

If extra time is your only accommodation — 30 minutes, 1 hour, 2 hours or 3 hours, and nothing else — you can book online the normal way. Candidate Bulletin, p. 7.

Everything else means calling Pearson NCLEX Candidate Services at the number printed on your ATT and asking for the NCLEX Accommodations Coordinator. That includes extra time combined with anything else. It's also who you ask for when you need to change an appointment later — even if you were allowed to make the original extra-time-only booking online. Candidate Bulletin, p. 7; NCLEX scheduling: accommodated appointment changes.

To add, change or cancel an accommodation, the request goes back to your board — not to Pearson. If you've already booked, you may have to unschedule in order to get a new ATT that reflects the change. NCSBN change instructions.

If you already booked before your accommodations were sorted out, contact your board about the accommodation and Pearson about the appointment. Do not assume the test center can fix it on the day, and do not let the appointment sit and hope.

If you're retaking the exam, ask your board what it needs before assuming your approval carries over. Indiana's packet says repeat candidates receive the same accommodations unless they request a change; a change requires a new request and supporting documentation. That is Indiana's instruction, not a nationwide automatic-renewal rule. Indiana packet, p. 2.

Changing or cancelling the appointment: the deadline

Give Pearson at least one full business day — 24 hours — of notice. For a Tuesday-through-Friday appointment, contact Pearson at least 24 hours before its date and time. For a Saturday, Sunday or Monday appointment, contact Pearson no later than Friday and at least 24 hours before the appointment time. Allow for national holidays and use the appointment's local time. NCLEX scheduling: changing an appointment.

For an accommodated appointment, speak to the Accommodations Coordinator through Candidate Services and obtain the confirmation email. A voicemail is not valid cancellation or rescheduling notice. Missing the deadline or not attending can forfeit the exam fee and invalidate the ATT. NCLEX scheduling: important notice and missed appointments.

If you're denied

Read the written reason and your board's instructions for submitting more evidence or appealing. Deadlines and review routes are board-specific; there is no single appeal process in the national Candidate Bulletin.

Arizona's policy provides one example. If staff don't have enough evidence to grant the accommodation, you are told what evidence is needed and you may submit more. You may also appeal staff findings to the Board in writing within 10 days of that notice. That is Arizona's deadline, not a deadline to apply to another board. Arizona policy, p. 2.

Check whether the stated problem is a missing recommendation, the age of the documentation or something else. Ask exactly what was missing and what the board will accept. If the dispute concerns repeated or burdensome documentation requests, compare the explanation with DOJ's testing-accommodations guidance rather than assuming you must buy another assessment.

Quick answers

Does requesting accommodations cost extra? The 2026 Candidate Bulletin's U.S. fee table lists the $200 registration fee, the international scheduling fee and the change fees. It lists no charge for testing accommodations. Your board's own license application fees are separate and apply either way. That fee-table observation is not a promise that obtaining documentation costs nothing: Indiana, for example, says applicants are responsible for costs incurred obtaining required documentation. Candidate Bulletin, p. 5; Indiana packet, p. 1.

Can I take the NCLEX at home as an accommodation? Not under the currently available NCLEX delivery options. NCSBN states that the NCLEX is given only inside the approved Pearson Professional Center network and is not currently available remotely. NCSBN has publicly described work on an online version, but no launch date has been announced; its current online-testing page says it is not launching in 2026. NCSBN remote-testing answer; NCLEX Online status.

Does an accommodation change the exam or make it easier to pass? An accommodation does not lower the passing standard. Extra time changes how long you have, not what you have to show. The Bulletin is clear that the passing standard is applied the same way to every exam record for the relevant exam; NCLEX-RN and NCLEX-PN are separate examinations with separate scales and standards. This does not mean every candidate receives identical questions. Candidate Bulletin, p. 26.

Will this show up on my license or go to employers? Do not assume a universal answer about licensing records or employer access. DOJ says test results must not be flagged to identify disability-related accommodations, but that does not establish every board's licensing-record policy. Indiana's Form C describes documentation as confidential and shared with NCSBN and the testing service for the purpose of arranging the accommodation. DOJ guidance: reporting results; Indiana Form C, p. 1. Arizona's policy states that accommodation requests are filed in the applicant's licensing file and are not public records. The same policy also states that if the request contains information suggesting the applicant's condition poses a risk to the health, safety and welfare of patients or the public, that information goes to the board's investigations department and an investigation may be conducted. That is Arizona's stated policy, not a rule to assume for another board. This is one worth asking your own board about directly rather than guessing. Arizona policy, p. 2.

Will accommodations limit my test date or location? They can affect the logistics, because arrangements need coordinating and availability matters. Indiana's licensing instructions tie arrangements to approval and test-center availability. Pearson specifically warns that a nursing-mother accommodation may require a center other than your preferred location. The sources checked do not quantify a nationwide reduction in available dates — but build travel and lead time into your planning. Indiana licensing instructions: special testing accommodations; Pearson nursing-mother guidance.

What if I'm breastfeeding or need to pump? Pumping is handled through the accommodation process. Request "access to nursing mother space" through your board and confirm the approved arrangements with Pearson before booking. At Pearson-owned centers in the Americas, the private pumping area may be a breakroom or a screened break area and is available first-come, first-served; outside that setting, Pearson describes making reasonable efforts to find a suitable space. Breastfeeding itself has to happen outside the testing facility, because children are not allowed in the test center. Ask how approved breaks, time and leaving/re-entering the facility will be handled. Indiana Form C, p. 2; Pearson nursing-mother guidance.

Your next step

Open your own board of nursing's accommodations page and compare its requirements against the checklist above. NCSBN keeps the directory of every U.S. member board with contact details and a link to each board's site: Find your board of nursing — NCSBN.

Three questions to get answered on that first contact:

1. How recent does my documentation have to be?
2. Do you need a letter from my nursing program, and who has to sign it?
3. Is this decided by staff, or at a board meeting — and when is the next one?

Candidates seeking a license in Canada or Australia go through their own regulator. The boards, forms and federal rule described above are U.S.-specific and don't apply outside the United States.

Sources and independence

• 2026 NCLEX Examination Candidate Bulletin (rev. 04/2026) — NCSBN. Printed pages: Program Overview, 3; Test Fees, 5; Registration Time Limit, 6; Test Accommodations, 7; Authorization to Test, 8; Changing Your Appointment, 10; Candidate Rules, 16; Breaks, 18; Passing Standard, 26.
• How do I request accommodations? and How do I change/add/cancel my accommodations? — NCSBN Help Center.
• NCLEX scheduling, Can I take the NCLEX remotely? and NCLEX Online status — NCSBN's current appointment and delivery guidance.
• Pearson VUE Comfort Aid List and Test accommodations — Pearson VUE. Follow the current item-specific and nursing-mother conditions.
• Accommodation Requests for NCLEX and NA/MA — Arizona State Board of Nursing. The NCLEX section, particularly pages 1–3, is the source here, not the nurse-aide or medication-assistant sections.
• NCLEX accommodation request packet, Form C and nursing licensing instructions — Indiana Professional Licensing Agency.
• Accommodations for NCLEX Testing and Board meeting calendar — Kansas State Board of Nursing.
• ADA Accommodation Request Form — Kentucky Board of Nursing. Use the current NCLEX Bulletin, not the form's older PN time reference, for the standard exam duration.
• Board Guidelines: NCLEX Test Accommodations (4/2024) — Minnesota Board of Nursing.
• 28 CFR § 36.309 — Examinations and courses and ADA Requirements: Testing Accommodations — the federal rule and U.S. Department of Justice guidance.

Last verified: 21 September 2026. We checked the cited NCLEX accommodation, scheduling, break, fee, ATT and delivery rules; Pearson's comfort-aid and accommodation guidance; the cited federal rule and DOJ guidance; and published accommodation instructions from Arizona, Indiana, Kansas, Kentucky and Minnesota. These are five selected boards, not a nationwide review of every board's documentation policy. Use your own board's current page and form before you submit anything.

This page was developed and source-checked with AI assistance. That is not a credentialed clinical or legal review. Castleport remains responsible for publication. Editorial standards.

Castleport Test Prep is an independent exam prep publisher. We are not affiliated with, endorsed by, or approved by the National Council of State Boards of Nursing (NCSBN), Pearson VUE, or any board of nursing. NCLEX and other exam and credential names are used only to identify the exams they name, and trademarks belong to their respective owners. This page explains published rules. It is not legal advice, and it is not a substitute for your board's own instructions. Your board is the contact for your accommodation request and determines your eligibility for a license; the exam arrangements require NRB authorization and coordination through the NCLEX process.

Castleport Test Prep Editorial Team