95: Alcpt Form

I certify that the ALCPT Form 95 was administered and scored according to DLIELC standardized procedures.

Signature: __________________________ Date: 16 April 2026 alcpt form 95

INDIVIDUAL SCORE REPORT

| Form | Raw Score | Change | |------|-----------|--------| | Form 90 | 71 | – | | Form 95 | 79 | | I certify that the ALCPT Form 95 was