Applications & Forms
Applications and forms are PDF files and require Adobe Reader. For best accessibility download the current Adobe Reader.
Applications
- Dentist *APPLY ONLINE*
- Sedation Applications and Forms
- Limited Dental License (Retired) (PDF)
- Resident Dentist (PDF)
- Dental Hygienist *APPLY ONLINE*
- Dental Therapist / Provisional Dental Therapist
- Dental Therapy Application *APPLY ONLINE*
- Dental Therapy Practice Agreement Outline (PDF)
- Dental Therapy - Verification of Clinical Practice (PDF)
- Provisional Dental Therapy Application *APPLY ONLINE*
- Provisional Dental Therapy Practice Agreement Outline (PDF)
- Independent Practice Dental Hygienist *APPLY ONLINE*
- Public Health Dental Hygiene Authority
- Public Health Dental Hygiene Authority *APPLY ONLINE*
- Public Health Practice Agreement (PDF)
- Nitrous Oxide Analgesia Authority *APPLY ONLINE*
- Local Anesthesia Authority *APPLY ONLINE*
- Denturist (PDF) *APPLY ONLINE*
- Denturist Trainee Registration (PDF)
- Dental Radiographer *APPLY ONLINE*
- Expanded Function Dental Assistant (PDF)
- Faculty License
- Dentist (PDF)
- Dental Hygienist
- Denturist
- Temporary License
Board Approved Programs and Licensure Examinations
- Dentist
- Denturist (Examinations)
- Denturist (Programs)
- Dental Hygienist and Dental Hygiene Practice Authorities
- Dental Radiography
- Expanded Function Dental Assistant
Forms
- Certificate of Education Form (PDF)
- Certificate of Denturism Program Completion Form (PDF)
- Certificate of EFDA Training/Program Completion Form (PDF)
- Certificate of Program/Course Completion Form (PDF)
- Continuing Education Log (PDF)
- CE Provider Pre-Approval Form (PDF)
- Credit Card Authorization Form (PDF)
- Complaint Form (PDF)
- Complaint Form - Online
- Data Request Form (PDF)
- Social Security Number Affidavit
If you cannot find what you are looking for, send an email to the Board of Dental Practice.