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TEST REVIEW REQUEST AND PAYMENT FORM Application

  • A $25 non-refundable test review fee must be paid.
  • Test Review requests must be received within three (3) business days from the official scoring of your test (excluding Saturdays, Sundays, and holidays).  Late requests will not be considered. 
PLEASE READ BEFORE FILLING OUT THIS TEST REVIEW REQUEST:
Please call D&SDT-HEADMASTER at (888)401-0462 during regular business hours, 7:00AM to 7:00PM Central Time (CT), Monday through Friday, excluding holidays, and discuss the test outcome you are questioning before committing to paying the $25 test review request deposit.  Once you have further details about the scoring of your test, you will often understand the scoring process and learn how to prepare yourself better for subsequent exam attempts.  If, after discussion with D&SDT-HEADMASTER staff, you still have a concern with your testing process that affected the outcome of your exam, you may submit this Test Review Request. The purpose of this review process is to ensure fairness and accuracy in the evaluation of your test. If, after investigation, the review finding is in your favor, you will be refunded the $25 test review deposit.  If the finding of the review is not in your favor, the $25 test review deposit will stand, and the fee is non-refundable.
 
Since one qualification for certification is demonstrated by examination of minimum knowledge as set by the state-approved test plan, the outcome of your review will determine who pays for your re-test.  If the review results are in your favor, D&SDT-HEADMASTER will pay your re-test fee. D&SDT-HEADMASTER will review your detailed recollection, your knowledge test markings, and any skill task measurements you recorded at the time of your test, in addition to reviewing markings, notations, and measurements recorded by the RN Test Observer at the time of your skill test if that is what the review request is about.  D&SDT-HEADMASTER will re-check your test component(s) scoring and may contact you and/or the RN Test Observer and professional Actor or Knowledge Test Proctor for any additional recollection of your test(s).  
 
After a candidate reaches the age of 18, D&SDT-HEADMASTER will only discuss test results or test disputes with the candidate D&SDT-HEADMASTER will not review test results or disputes with instructors/training programs, family members, or anyone else on behalf of the candidate. 
  • Read the Test Review Request section in the Candidate Handbook.
  • To request a review, complete and submit this Test Review Request and Payment Form.   
  • Pay the non-refundable $25 fee (Visa, MasterCard, or debit card).  
  • Provide a detailed explanation of why you feel your dispute is valid.
  • Test Review requests must be received within three (3) business days from the official scoring of your test (excluding Saturdays, Sundays, and holidays).  
    • Late requests will not be considered. 
  • D&SDT-HEADMASTER will complete your review request within ten business days of receiving your timely review request.
  • The final determination of the review results will be sent to the email address listed in your TMUĀ© account, along with a notification to your State agency.
Your application is not complete until you include the required information and select 'Send Application.'
Social Security Number (SSN) or Individual Taxpayer Identification Number (ITIN)
Address
TEST DATE INFORMATION
ETAILED EXPLANATION OF CIRCUMSTANCES TO BE REVIEWED
Affidavit
I have read the Test Review Section of the Candidate Handbook.

I understand:
  • My credit/debit card will be charged the $25 test review fee. 
    • The test review fee is non-refundable if the determination is not in my favor.
  • This review request must be submitted within three (3) business days of receiving my test results, excluding Saturdays, Sundays, and holidays.
    • Please note that late requests submitted after three (3) business days, excluding Saturdays, Sundays, and holidays, will not be considered.
  • I have provided a detailed explanation of the circumstances I am asking for to be reviewed.
  • The final determination review results will be sent to my email address and the State agency. 
By Submitting
I hereby verify that I understand and agree with the statements contained herein and the above information is true and correct.
Application Fee $25.00
Non-Refundable. All fees are non-refundable.