There is a great need to explore approaches for developing computer-based testing systems that are more accessible for people with disabilities. This report explores three prototype test delivery approaches, describing their development and formative evaluations. Fifteen adults, 2 to 4 from each of the six disability statuses--blindness, low vision, deafness, deaf-blindness, learning disability, and no disability--participated in a formative evaluation of the systems. Each participant was administered from 2 to 15 items in each of one or two of the systems. The study found that although all systems had weaknesses that should be addressed, almost all of the participants (13 of 15) would recommend at least one of the delivery methods for high-stakes tests, such as those for college or graduate admissions. The report concludes with recommendations for additional research that testing organizations seeking to develop accessible computer-based testing systems can consider.