Score Request « Southern Regional Testing Agency

Please fill out the Score Request form below.

Score Request

Personal Information
Name*
First Middle Last
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Name
First Middle Last
Last 4 digits of SSN*
Phone*
Email*
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Current Mailing Address
Address*
Street Address Address Line 2 City State ZIP Code

Physical Address, no PO Boxes
Exam Details
Exam Location*
Year You Took the Exam*
Have you taken the exam more than once?
- Yes
If yes, please enter additional exam locations and years.
Exam type:*
Address to Send Scores
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Institute:
Address
Street Address Address Line 2 City State ZIP Code
Comments
Fee Information
Do you want score request notarized?*
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- Yes
Duplicate Score
Price: $35.00
Notarize
Price: $5.00
Total
$0.00
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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

Current Mailing Address

Exam Details

Address to Send Scores

Fee Information

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