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applications and forms

Below are the forms that the Iowa Dental Board has made available for electronic distribution.

Most of the forms are in .pdf , and require Adobe Reader to view. If you do not have Adobe Reader, you can download that software here.  Other forms are available in .html and you can view them in your web browser.

Applications


     Dental License

     Conscious Sedation Permit

     Deep Sedation - General Anesthesia Permit

     Temporary Permit

     Dental Hygiene License

     Local Anesthesia Permit

     Dental Assistant Trainee

     Dental Assistant Registration and Qualification

     Qualification in Dental Radiography

     Reinstatement of Qualification in Dental Radiography

 

Electronic Submission Forms


.html     Change of Address

.html     Complaint Form

.html     Electronic Newsletter Sign-up

.html     Web site Feedback

 

Forms

     Prior Approval for Expanded Function Training

     Sample Expanded Functions Documentation Form

     Public Health Supervision Agreement

     Public Health Supervision Reporting Form

     Complaint Form

.html     Purchase a Roster/Mailing List

.html     Disciplinary Action Subscription Service

 

Continuing Education Applications & Forms


     Prior Approval of a Continuing Education Course

     Post Approval of a Continuing Education Course

     Prior Approval for Expanded Function Training

     Sample Expanded Functions Documentation Form

     Sample Continuing Education Record

     Continuing Education Sponsor Application

     Sponsor Attendance Record Report

     Application for Exemption or Extension of Continuing Education Requirements

     Application for Inactive Status

 

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