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COVID -19 Update

For the latest information about Mercy’s COVID-19 policies click here.  STUDENTS: To upload your vaccination documentation, click here.  

Proctor Request Form

Proctor Request Form

We require at least 7 days notice to guarantee the accommodation. 

We will still accept late forms and will make every effort to accommodate, we just cannot make any guarantees without a week's notice. 

Please do not submit forms more than 3 weeks in advance. 

Student Information

Requested Accommodations

Accommodation Options

Instructor & Exam Information

Is this exam for a NURSING student? *
Is this exam an ATI or Kaplan exam? *

Exam Information

Student, please work with your professor to complete the section below and ensure all information is accurate. Discrepancies with exam information will delay processing. 

Date and time of exam*
Will lecture resume after the exam?*

Due to limited hours, it may be necessary to arrange testing at an alternative date/time than the regular class exam.

  • Dobbs Ferry available testing hours: 9 AM–5 PM, Mon–Fri or by appointment
  • Bronx and Manhattan by appointment
Please indicate an alternative date and time to take the exam:
How will professor deliver exam to ACCESSibility Office? *
How will professor retrieve completed exam? *
Example: calucalator, scratch paper, formula sheet, etc.