NCCSA » Exam Application

Application Number*
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Certification application fees are non-refundable.
Are You Recertifying?
If you are applying for recertification and want to recertify by submitting CEUs and not by examination please use the Recertification Form instead.
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Fees
The following fees are associated with your application.
MD/DO $350
Price:
Graduate from an accredited and NCCSA approved SA Educational Program $350
Price:
New Graduate (graduated within last 12 months) $200
Price:
Examination fee $350
Price:
Recertification fee $300
Price:
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Supported Credit Cards: American Express, Discover, MasterCard, Visa
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Rules & Regulations*
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By submitting this form you agree to the rules and regulations and the Ethical Standards of the NCCSA.
Payment Policy Agreement*
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You are bound by the payment policy of the NCCSA.

Special Accommodations and submit via Regular MAIL Instructions

If you need special test accommodations please contact our office at 855-277-3926.

If you would like to submit your payment via MAIL, fill it out the form first, DO NOT CLICK SUBMIT when you are done, and go to File > Print to print what you've filled out. You can them mail in the printout to 1775 Eye Street, NW, Suite 1150, Washington, DC 20006.

Exam Application

Are You Recertifying?

Information

Fees