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
Permits
Dental Hygienist (DH) Applications
Licensure
Permits
- Dental Hygienist - Approval to Administer Local Anesthetics (Apply Online)
- Dental Hygienist - Local Anesthesia Reinstatement Checklist
- Dental Hygienist - Approval to Place Interim Therapeutic Restorations (ITR) (Apply Online)
- 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
Academic Dentist (AD) Applications
Licensure
Anesthesia Permits