NCLEX accommodations: who approves them and what order to follow

Your nursing regulatory body approves NCLEX accommodations, and you ask before you register with Pearson. Here is the order of steps, how to schedule once approved, and what needs no approval.

Why the nursing regulatory body decides, not Pearson or NCSBN

If you have been searching for where to send your request, the most common mix-up is assuming Pearson or NCSBN receives it. The bulletin says testing accommodations for otherwise qualified candidates can be provided only with the authorization of your NRB. Pearson then works from what the board has approved.

What each organization handles

The bulletin splits contact responsibilities clearly, and it helps to keep them straight.

1. Your NRB: Handles licensure and registration, your NRB application, testing accommodations and exceptions, name or address changes, and name corrections on your ATT email. Your results also come from the NRB.
2. Pearson: Handles registering to take the NCLEX, payment methods, the ATT email, scheduling and rescheduling, acceptable ID and comments about the test center.
3. NCSBN: Handles NCLEX development, general NCLEX information and general questions about exam administration. It does not approve accommodations.

What this means for phone numbers and who to call

There is no single "NCLEX accommodations phone number" for requests, because the request goes to your board. The bulletin points to the NCSBN directory of nursing regulatory bodies for board websites and contact details, so start there and look for your board's accommodations instructions. Pearson also runs many other exam programs, so a general accommodations page you find through a search may not describe the NCLEX process. For the NCLEX, the bulletin and nclex.com are the reference.

Pearson NCLEX Candidate Services is the number for scheduling once you are approved: 1.866.496.2539 (toll-free, United States and Canada), Monday to Friday, 7:00 a.m. to 7:00 p.m. Central Standard Time. If you use a Telecommunications Device for the Deaf, the bulletin lists the U.S.A. Relay Service at 1.800.627.3529 (toll-free) and the Canada and International Inbound relay service at 605.224.1837 (pay number), both available 24 hours a day, seven days a week. Callers outside the U.S. and Canada have other numbers in the bulletin.

How to request NCLEX accommodations, step by step in prose

The bulletin's Test Accommodations section gives three actions, plus a rule about scheduling. The registration overview adds that accommodation or exception requests go to your NRB at the time you apply for licensure or registration.

Step 1: Find out your board's requirements

Ask your NRB what it requires for candidates requesting testing accommodations. The bulletin says to do this before submitting your NCLEX registration to Pearson. The nclex.com Registration page repeats it: if you are testing with accommodations, request them with the NRB prior to registration.

Step 2: Make a written request

Put your request in writing to your NRB. The bulletin says your request must comply with the requirements your NRB has established. That means the board's format, forms and documentation come first, and a general letter that ignores them can slow things down.

Step 3: Send it early

The bulletin asks you to send your request as early as possible so that, if approved, the accommodations can be made in a timely manner. It does not promise a turnaround time, and boards work at different speeds. Treat this as the step to do first rather than the one you squeeze in later.

Step 4: Register with Pearson only after you've asked

The sequence in the bulletin runs like this: you apply to your NRB, meet its eligibility requirements, register with Pearson, receive a Registration Acknowledgment email, and then the NRB makes you eligible in the Pearson system. After that Pearson sends your ATT email. Your accommodations request belongs at the very start of that chain, not after registration.

Step 5: Wait for written confirmation and an ATT that lists accommodations

The bulletin is direct here: do not schedule until you have both the written confirmation of your accommodations and the ATT email listing the granted accommodations. Two timing facts matter while you wait. Your NCLEX registration stays open for 365 days while the NRB determines eligibility, and if you are not made eligible in that time you forfeit the registration, including the fee. Once your ATT arrives, it is valid for a period set by the NRB (the average is 90 days) and cannot be extended for any reason.

If more than two weeks have passed since Pearson acknowledged your registration and you have no ATT, the bulletin suggests contacting your NRB to check that everything was received.

What documentation will your board ask for?

Documentation is set by the board, not by NCLEX

The sources do not list what documentation counts, and they do not name which conditions qualify. They say only that your request must meet your NRB's own requirements. So the answer to "what do I need" is always on your board's page or from its staff.

Some boards publish their own forms

Some boards publish a dedicated accommodation form or checklist for NCLEX candidates, and the specifics vary. A form might ask for professional documentation or for verification from your nursing program, but you should not assume that about your board. Read what your board posts and ask them directly if anything is unclear.

ADHD, anxiety and other conditions

Candidates often search for accommodations for ADHD or anxiety. The bulletin does not tie any accommodation to a particular diagnosis. Your board decides based on its own criteria, so the useful next steps are to read your board's instructions and talk with your board and the professional who treats you about what documentation would be appropriate. Nothing here can tell you what a board will approve.

Scheduling once you're approved

Extra-time-only approvals can book online

If your only approval is extra time of 30 minutes, 1 hour, 2 hours or 3 hours, you may schedule online at nclex.com/scheduling. The bulletin is specific that this applies only if you were approved for one of those and no additional accommodations.

All other accommodations go through the NCLEX Accommodations Coordinator

If you were approved for anything else, or for extra time plus something else, you schedule by calling Pearson NCLEX Candidate Services at the telephone number listed on your ATT and asking for the NCLEX Accommodations Coordinator. Because both scheduling timing and available arrangements can differ for accommodated appointments, confirm the details with the coordinator rather than assuming the standard timelines apply. For reference, the standard rule is that first-time candidates are offered an appointment within 30 days of the request and repeat candidates after 45 days.

Changing an appointment with accommodations

To change a date, time or location, the bulletin says to ask for the NCLEX Accommodations Coordinator. The usual notice rule still applies: change it at least one full business day (24 hours) ahead. Leaving a voicemail does not count as notice. Missing an appointment without proper notice forfeits your exam fee and invalidates your ATT.

One more rule: candidates with accommodations cannot cancel their accommodations at the time of their appointment.

What appears on your ATT

Your ATT email contains your authorization number, candidate identification number and expiration date, and for accommodated candidates it lists the granted accommodations. Check it against your board's written confirmation. If something does not match, or your name needs correcting, go back to your board, since name corrections on the ATT are an NRB matter. The name on your ID must match the name on your ATT exactly, and arrive at least 30 minutes before your appointment.

Comfort aids: what needs no pre-approval

Where the official Comfort Aid List lives

The nclex.com Registration page has a section labeled "Comfort Aid List (do not require pre-approval)." The text available does not spell out the items, so this article will not guess. Read the list on nclex.com before exam day rather than relying on a forum post or a friend's memory.

What the bulletin says about medical aids and electronics

Medical aids and devices are not allowed in the testing room, but they may be accessed while on break. Electronic devices must be powered off and stored in a plastic bag from Pearson. Earplugs are available from the test administrator on request, and you may not bring your own.

If you need something that is not on the Comfort Aid List, treat it as an accommodation or exception question for your board, and ask well before exam day. Needs related to pumping or breastfeeding are the kind of exception request to raise with your board.

Security scan exceptions

Everyone completes a security scanning protocol before entering the testing room. If you refuse the scan and do not have a pre-approved exception from your NRB, you will be turned away and forfeit your exam fee. If a scan is a concern for you, that is a conversation to have with your board in advance.

Planning your study schedule around the accommodation process

Build the approval wait into your timeline

Because you ask the board before registering, and the ATT clock only starts when the board makes you eligible, the approval process sits at the front of your timeline. A reasonable rule of thumb is to start the conversation with your board as soon as you begin your licensure application, then plan your study window around the ATT dates once you have them. Do not let paperwork drift: the ATT average of 90 days is short, and test centers can fill up. If you wait until your ATT is close to expiring, the center may not be able to seat you, and you would need to reregister and pay another fee.

What extra time does and doesn't change

The bulletin describes the standard exam as 85 to 150 items with a five-hour limit that includes the introductory screen and all breaks. Breaks are optional and offered after about two hours and about three and a half hours, and the clock keeps running during them. The bulletin lists extra time in increments from 30 minutes to 3 hours, but it does not say what any board will grant you. Confirm how your approved time works with your board and the coordinator.

Studying the exam you'll actually sit

The waiting period is useful. The bulletin points to a free tutorial at nclex.com/prepare that explains the item formats and the software, and an on-screen calculator is available during the exam. For content, the structure is the same process for both exams, so use the 2026 NCLEX-RN® test plan guide or the NCLEX-PN test plan guide to see how the Client Needs categories are weighted and shape a plan around your weaker areas.

Common mistakes and quick checklist

None of these are signs of carelessness. The process has several handoffs between organizations, and they are easy to mix up.

1. Registering with Pearson first: The bulletin and nclex.com both say to ask your NRB about accommodations before registering. Starting with Pearson puts the registration clock (365 days) running before your request is sorted.
2. Scheduling before the ATT lists your accommodations: The bulletin says not to schedule until you have written confirmation and an ATT that lists them. If you book online and you are not in the extra-time-only group, you risk a mismatch.
3. Assuming one board's process applies to another: Forms, documentation and timing are set by each NRB. A friend's experience in another jurisdiction is not a guide to yours.
4. Waiting until the ATT is close to expiring: ATT dates cannot be extended and fees are not refunded for missed appointments. Schedule soon after you hold the ATT.

For a quick checklist: confirm your board's requirements, send a written request early, register with Pearson, watch for the ATT, confirm it lists your accommodations, then schedule online if extra time only, or through the NCLEX Accommodations Coordinator if not. You can find more NCLEX guides on exam logistics and study planning as you work through each step.

PreceptIQ, an NCLEX® coach that studies your mistakes, is coming to iPhone and Android at https://preceptiq.app, and it is a study aid rather than a guarantee.

Common questions

NCLEX®, NCLEX-RN® and NCLEX-PN® are registered trademarks of the National Council of State Boards of Nursing, Inc. (NCSBN®). PreceptIQ is not affiliated with, endorsed by, or sponsored by NCSBN.