Colorado Dental Board: Applications and Forms

Forms

• Practice Ownership
• Inspector Report for Deep Sedation/General Anesthesia
• Inspector Report for Moderate Sedation
• Office Inspection Only - for dentists that contract anesthesia administration out to non-dentists

Dentist (DEN) Applications

Licensure

Licensure

• Dentist - Original License by Examination or Endorsement (Apply Online)
  • Online Application Checklist
• Dentist - Reinstate Expired License (Apply Online)
  • Online Reinstatement Checklist
• Dentist - Change Status to Inactive
• Dentist - Change Status to Retired
• Dentist - Reactivate Inactive or Retired License

Anesthesia Permits

Permits

• Dentist - Approval to Administer Anesthesia (Apply Online)
  • Anesthesia Checklist
• Dentist - Renewal to Administer Anesthesia
• Dentist - Reinstatement to Administer Anesthesia

Dental Hygienist (DH) Applications

Licensure

Licensure

• Dental Hygienist - Original License by Examination or Endorsement (Apply Online)
  • Online Application Checklist
• Dental Hygienist - Reinstate Expired License (Apply Online)
  • Online Reinstatement Checklist
• Dental Hygienist - Change Status to Retired
• Dental Hygienist - Change Status to Inactive
• Dental Hygienist - Reactivate Inactive License

Permits

Permits

• Dental Hygienist - Approval to Administer Local Anesthetics (Apply Online)
  • Local Anesthesia Checklist
• Dental Hygienist - Local Anesthesia Reinstatement Checklist
• Dental Hygienist - Approval to Place Interim Therapeutic Restorations (ITR) (Apply Online)
  • ITR Checklist
• Dental Hygienist - Approval to Place Interim Therapeutic Restorations (ITR) (Download Paper Application)
• Dental Hygienist - ITR Verification of Training Form
• Local Anesthesia Training Form

 Dental Therapists (DT) Applications

Licensure

Licensure

• Dental Therapist - Original License by Examination (Apply Online)
  • Online Application Checklist
• Dental Therapist - Reinstate an Expired License (Apply Online)
  • Online Reinstatement Checklist
• Dental Therapist - Change Status to Retired
• Dental Therapist - Change Status to Inactive
• Dental Therapist - Reactivate Inactive License

Permits

Permits

• Dental Therapist - Approval to Administer Local Anesthetics (Apply Online)
  • Local Anesthesia Checklist
• Dental Therapist - Local Anesthesia Reinstatement Checklist
• Local Anesthesia Training Form

Academic Dentist (AD) Applications

Licensure

Licensure

• Academic Dentist - Original License (Apply Online)
• Academic Dentist - Reinstate Expired License (Apply Online)
  • Online Reinstatement Checklist

Anesthesia Permits

Anesthesia Permits
 

• Academic Dentist - Approval to Administer Anesthesia (Apply Online)
• Academic Dentist - Renewal to Administer Anesthesia
• Academic Dentist - Reinstatement to Administer Anesthesia