Test Proctoring Proctor Request Form Name First Last Email PhoneWith which UW-Madison school/dept are you affiliated? Test you need proctored, e.g., class number/title Due date (the deadline for the test to be taken) MM slash DD slash YYYY Days / times you’d be available to take the test at Ebling please give us at least 2-3 business day lead timeApproximately how long will the test take? Do you need anything special from the proctor? Yes No e.g. need any forms signed, is the test password protected, etc.If yes, please explain Health sciences test(Required) I am a health sciences student or other individual taking a health sciences examStudents not in the health sciences or not taking a health sciences exam can schedule a proctored exam through UW’s Testing and Evaluation Services website.Any other comments, questions, etc. Δ