EIPA Grievance Form

EIPA Grievance Form

I. EIPA TEST GRIEVANCE POLICY

Test candidates may file a grievance claim if a significant, unusual event or condition related to the administration of the assessment caused an adverse effect on the performance or ability to take the exam.
Grievances based on the design or content of the assessment will not be considered.
The EIPA Grievance Form must be completed and submitted within 7 calendar days of the test date.
Grievance claims will not be considered if submitted after the test candidate is notified of their test results or after the 7-day deadline to submit the grievance form.
Grievances based on a disagreement with a score will not be considered.
- Because the EIPA written test results are provided to test candidates immediately after submitting the test, written test candidates should NOT submit the written test if they feel a significant event has adversely affected their performance. Candidates must notify the test administrator immediately if an event occurs. Instead of submitting the exam, discuss rescheduling your test with the test administrator. Grievance claims will not be considered after the written test has been submitted, thereby notifing the test candidates of the exam results.
Any abnormalities that occur during testing must immediately be brought to the attention of the test administrator. The test administrator will attempt to correct the situation and proceed with testing. If the problem cannot be corrected, the test administrator and test candidate can agree to proceed or reschedule.
A confirmation of receipt of your grievance form will be sent within 1 business day. IF YOU DO NOT RECEIVE A CONFIRMATION, IT IS YOUR RESPONSIBILITY TO CALL 531-355-5039 TO CHECK ON THE STATUS OF YOUR FORM. Failure to check the status if no confirmation is received will impact your claim if the 7-day deadline passes.

NOTE: Experiencing an environmental abnormality during testing doesn’t automatically mean a grievance claim will be approved and a new test granted. For example, a delay in the start time of the written test due to techincal issues, may not be considered a significant unusual event. Environmental and administrative events occur during most tests. Events inside or outside the building may produce sounds that can be heard in the room. Videos may freeze, computers may temporarily lose connection, a fire truck may drive by the building. When investigating grievance claims, EIPA will evaluate the level of significance of the event. Each grievance will be judged on a case by case basis.

INSTRUCTIONS TO FILE A GRIEVANCE CLAIM

Complete the form below and submit within 7 calendar days from the date of the test.
A confirmation of receipt of your grievance form will be sent within 1 business day. IF YOU DO NOT RECEIVE A CONFIRMATION, IT IS YOUR RESPONSIBILITY TO CALL 531-355-5039 TO CHECK ON THE STATUS OF YOUR FORM. Failure to check the status if no confirmation is received will impact your claim if the 7-day deadline passes.

Today's Date*

MonthDayYear

Test Date*

MonthDayYear

Name*

First NameLast Name

Email*

Phone Number*

Test Administrator Name*

Test Location (City and State)*

Type of Test*

Performance TestWritten Test

Reason for filing a grievance*

Did you inform the test administrator of the issue during testing?*

YesNo

Did the test administrator attempt to solve the problem?*

YesNo

Please explain steps taken by the test administrator.

File Upload

Upload supporting documentation (optional).

An email confirming receipt of your grievance form will be sent within 1 business day. If you do not receive confirmation within 1 business day, call EIPA at 531-355-5039

IF YOU DO NOT RECEIVE A CONFIRMATION EMAIL, IT IS YOUR RESPONSIBILITY TO CALL 531-355-5039 TO CHECK ON THE RECEIPTOF YOUR FORM. FAILURE TO CHECK THE STATUS IF NO CONFIRMATION IS RECEIVED WILLIMPACT YOUR CLAIM IF THE 7 DAY DEADLINE PASSES.

Grievance claims;submitted after the 7-day deadline or if the results of the test have already been received (refer to number 4 under EIPA Test Grievance Policy) will not be accepted. During the investigation process, you may be contacted if additional information is needed. In all cases, the decision as to whether the circumstance(s) qualify as a grievance event will be at the sole discretion of the EIPA Diagnosis Center.