Reasonable Adjustment Application Form

Application Overview

Reasonable adjustments help ensure that learners with disabilities, learning difficulties, or other access needs are assessed fairly.

Please complete this application in accordance with the following:

Submit a separate application for each learner
Apply at least 5 working days before the first assessment date
Ensure the learner is registered on QMIS before requesting extra time in XAMS
Contact FutureQuals directly for Special Consideration applications
Refer to the Reasonable Adjustments and Special Considerations Policy for full guidance
Keep a record of all applications and outcomes, including declined requests

Learner Number *

If the learner has not yet been registered, please enter TBC (to be confirmed). Once the learner has been registered, please contact us by email to confirm and update the learner number.

How were the learner’s additional need(s) identified? *

Please describe how the learner's additional need(s) were identified and provide supporting evidence. Include any relevant assessments or reports, recommended adjustments, and details of the learner's normal way of working.

Evidence must be reviewed by appropriately qualified staff to confirm it is current and relevant to the learner.

Acceptable types of evidence may include (but are not limited to):

A Statement of Special Educational Needs (SEN) or Education, Health and Care Plan (EHCP) confirming a disability or learning difficulty
A letter from a hospital consultant, GP, or Occupational Health professional
A specialist assessment carried out from Year 9 onwards, including standardised test scores

If formal evidence is not available, a documented history of need within the centre may be used. This should include records of:

Support provided during the learning programme
Adjustments used in formative assessments
Evidence of the learner’s normal way of working

All evidence must be retained for audit purposes.

Reasonable adjustment(s) requested *

Extra time up to 25%

Extra time in excess of 25% (provide further information in details of the application)

Reader

Scribe

Coloured overlay

Seperate room

Other (please provide details of reasonable adjustment(s) requested

Please only select those for which you have supporting evidence.

Facilitator(s) access guidance

Please provide details of access facilitator(s), for example reader and/or scribe (in addition to an invigilator where the application relates to a controlled assessment).

Guidance for readers and scribes can be obtained from FutureQuals. Please ensure that scribes and readers understand what they can and cannot do to support a learner.

I confirm that:

The appropriate evidence has been attached to support the application

The information provided is accurate

The centre will be able to provide the arrangements requested

The reasonable adjustments will be implemented in accordance with FutureQuals' guidance

FutureQuals Reasonable Adjustment Application Form

Application Overview

Centre and Learner Details

Assessment Details

Needs Identification & Evidence

Requested Reasonable Adjustments

Confirmation & Submission

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