Written Exam Rescore Application Form

NDAEB Written Exam Rescore Application

"*" indicates required fields

1Personal Information

2Fees and Payment

Rescore Request Details

Please complete the following form to request a rescore of your NDAEB Written Examination. Requests for rescoring must be received by the NDAEB office no later than thirty (30) days after the date appearing on your results letter. For more details on the rescore process please refer to the "Examination Re-Scoring" section in the Written Examination Candidate Handbook.

Name*

First Middle Last

Note: If you do not have a legal last name/surname, please enter a period (.) as a placeholder in the last name field.

NDAEB ID*

Please enter your assigned 8-digit NDAEB Applicant ID number.

Home Address*

Street Address/PO Box Suite/Apartment City State / Province / Region ZIP / Postal Code Country

Email Address*

Enter Email Confirm Email

Alternate Email Address

Enter Email Confirm Email

Primary Phone*

Alternate Phone Number

Examination Session*

Select the examination session for which you wish to request a rescore.

Signature*

I request that the NDAEB re-score my results for the Written Examination that I have selected.

Printed Name:*

Date:*

National Dental Assisting Examining Board
Bureau national d'examen d'assistance dentaire

NDAEB Written Exam Rescore Application

Rescore Request Details

Rescore Fees and Payment Details

ADDRESS

CONTACT

OFFICE HOURS

ADDITIONAL INFO

National Dental Assisting Examining Board Bureau national d'examen d'assistance dentaire

NDAEB Written Exam Rescore Application

Rescore Request Details

Rescore Fees and Payment Details

ADDRESS

CONTACT

OFFICE HOURS

ADDITIONAL INFO

National Dental Assisting Examining Board
Bureau national d'examen d'assistance dentaire