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Virginia Board of Dentistry
Forms, Applications, and Exam Info

Unless otherwise noted, the below documents are in Microsoft Word format. If you do not have Microsoft Word, you can get the Microsoft® Word Viewer 97/2000 to view and print documents. To view the PDF files below you'll need the free Adobe Acrobat Reader.

Dentist / Dental Hygienist Forms

Applicants for a Dental license (by Examination or Credential) or a Dental Hygienist license (by Examination or Endorsement) are now accepted online. Click here to begin the online application process for a Dental license or Dental Hygienist license.

View the Instructions for Dental license

View the Instructions for Dental Hygienist license



Restricted Volunteer License to Practice Dentistry and Dental Hygiene - Application and Instructions - Revised June 11, 2014

Reactivation application for Dentists and Dental Hygienists - Revised June 3, 2014

Reinstatement application For Dentist and Dental Hygienist - Revised June 3, 2014

Deep Sedation/General Anesthesia

Permit To Administer Deep Sedation/General Anesthesia Application - Refised July 29, 2014

Conscious/Moderate Sedation

Permit To Administer Conscious/Moderate Sedation Application - Revised July 29, 2014

Application for Dental Temporary Restricted Permit (§54.1-2715) - contact the Board of Dentistry for an application

Application for Restricted License to teach dentistry for foreign dentists (§54.1-2714) - contact the Board of Dentistry for an application

 

Oral and Maxillofacial Surgeon/Cosmetic Procedure Certification

Oral and Maxillofacial Surgeon Registration of Practice - Revised May 27, 2014

Oral And Maxillofacial Surgeon Reinstatement Of Registration Of Practice - Revised May 27, 2014

Certification to Perform Cosmetic Procedures Application - Revised May 27, 2014

 

Temporary Resident / Faculty / Mobile Dental Facility / Portable Dental Operation

Application for Temporary Resident’s License - Revised June 11, 2014

Mobile Dental Facility or Portable Dental Operation Application for Registration - Revised June 3, 2014

Application for a Faculty License to Teach Dentistry – Revised June 10, 2014

Application for a Dental Hygiene Faculty License - Revised June 3, 2014

 

Volunteer Practice Forms

Instruction Sheet - Revised Octobober 28, 2013

Volunteer Practice Sponsor Form - Revised October 28, 2013

Application for Registration for Volunteer Practice - Revised March 2014

 

Dental Assistants II

Instructions for Dental Assistant II Applicants - Revised May 31, 2013

Application for Registration as a Dental Assistant II - Revised June 11, 2014

Form A - Certification Of Dental Assisting Education - Revised May 30, 2014

Form B - Duties - Revised Feb. 14, 2014

Form C - Certification Of Authorization To Perform Expanded Duties As A Dental Assistant - March 23, 2011

 

Exam Information

Regional Examinations

CITA (Council of Interstate Testing Agencies) www.citaexam.com
Effective September 1, 2007 accept passing scores

CRDTS (Central Regional Dental Testing Services, Inc.) www.crdts.org
Effective January 1, 2005 accept passing scores

NERB (North East Regional Board) www.nerb.org
Effective Jan. 1, 2005 accept passing scores

SRTA (Southern Regional Testing Agency) www.srta.org
Accept passing scores from any year

WREB (Western Regional Examining Board) www.wreb.org
Effective 1, 2005 accept passing scores

National Boards

Administered by the American Dental Association www.ada.org

Inspection Form

76-24.3, Dental Office Inspection Report, June 13, 2014 (MS Word)

Dental Lab Work Orders

Dental Laboratory Work Order Form (pdf) - Revised Dec. 2012

Dental Laboratory Subcontractor Work Order Form (pdf) - Revised Dec. 2012

 

Miscellaneous Forms

Name/Address Change Form - Revised March 18, 2014

Request for Verification of Virginia Dentist/Dental Hygienist License - Revised March 18, 2014