Score Request « Southern Regional Testing Agency

Please fill out the Score Request form below.

Score Request

Personal Information
Name*
First Middle Last
If your name has changed, please fill in your original name.
Madien Name (If applicable)
Last
Last 4 digits of SSN*
Phone*
Email*
Enter Email Confirm Email
Exam Details
Year You Took the Exam*
Exam Location*
Exam type:*
Have you taken the exam more than once?
- Yes
If yes, please enter additional exam locations and years.
Do you want your score request notarized? (Extra $5)*
- No
- Yes
Address to Send Scores
Institute:
Address
Street Address Address Line 2 City State ZIP Code
- Same as Current Mailing Address
Current Mailing Address
Address*
Street Address Address Line 2 City State ZIP Code

Physical Address, no PO Boxes
Comments
Fee Information
Duplicate Score
Price: $35.00
Notarize
Price: $5.00
Total
$0.00
Payment Information*

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name

Hit the 'Submit' button 1 time only.

Our Mission

SRTA will continue to provide valid, reliable, legally defensible examinations and results while striving to implement new testing methodologies in a candidate friendly environment for the next generation of dental professionals.

Southern Regional Testing Agency (SRTA)

4698 Honeygrove Rd., Suite 2
Virginia Beach, VA
23455

Office Hours
Monday – Friday 8:30a.m. – 5:00p.m. EST
phone: (757) 318-9082 | fax: (757) 318-9085

Score Request

Score Request

Personal Information

Exam Details

Address to Send Scores

Current Mailing Address

Fee Information

Quick Links

Online Registration

Exam Score Request

Dental Exam Calendar

Dental Hygiene Exam Calendar

Our Mission