RSA PT Portal Dashboard

Account Info

First Name *

Last Name *

Email *

Password *

Laboratory Billing Information

Billing Agency/Lab/Company Name *

Billing Contact - Full Name *

Billing Address Line 1 *

Billing Address Line 2

Billing Country *

Billing State/Providence/Region *

Billing City *

Billing ZIP/Postal Code *

Billing E-Mail Address *

Billing Phone Number *

Same as Billing Information

Laboratory Shipping Information

Shipping Agency/Lab/Company Name *

Attention: *

Shipping Address Line 1 *

Shipping Address Line 2

Shipping Country *

Shipping State/Providence/Region *

Shipping City *

Shipping ZIP/Postal Code *

Shipping Phone Number *

Are you required by ANAB, A2LA, or any other accrediting body to submit this proficiency test data to meet external proficiency test requirements? *

Yes

Primary Point of Contact

Primary POC Full Name *

Primary POC Job Title *

Primary POC Email Address *

Primary POC Phone Number *

Secondary Point of Contact (Optional)

Secondary POC Full Name

Secondary POC Job Title

Secondary POC Email Address

Secondary POC Phone Number

Add more user accounts to this lab

First Name *

Last Name *

Role *

Email *

Password*

Allow Technical Review

** Check the disciple(s) the user may perform technical reviews.

Allow Administrative Review

** Check the disciple(s) the user may perform administrative reviews.

Name	Email	Role	Action

RS&A Proficiency Testing Portal

Registration

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