Dc Dental Form. The dental provider should complete part 2. Web the dc department of health recommends that children 3 years of age and older have an oral health examination performed by a licensed dentist and have the dc oral health assessment form completed.
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Web oral health assessment form. Please indicate the ward of your home address, list primary care provider, dental provider, and type of dental insurance. Web how you can fill out the 37 dental dc form on the web: Instructions complete part 1 below. Make sure you take the correct exam and complete the correct answer sheet for your license type. The following documents are required annually for all grades as part of the dcps. Character reference letter [pdf] supervised practice form for pending application [pdf] application checklist [pdf] authorization to release information form (third party) [pdf] Submit your completed answer sheet with your license application. Take this form to the student's dental provider. Web dentistry initial license application documents.
Return fully completed and signed form to the student's school/child care facility. The applications for the board of dentistry must include all documents listed on the application checklist below. Easily fill out pdf blank, edit, and sign them. Submit your completed answer sheet with your license application. If you require more space for work experience or need to provide explanations for screening questions, attach typed responses to the form. Apache trail #102 apache junction, az 85120. Web district of columbia oral health (dental provider) assessment form. Complete all information in the dentist section including your social security number or tax i.d. To start the form, use the fill camp; The board reviews each application package and determines an applicant's eligibility for a license. Web dentistry initial license application documents.
