Forms

Please select a category from the dropdown to view related forms and applications.

Please use our Application Wizard for guidance on how to apply for initial licensure as a Dentist.

Please note: CLINICAL EXAMINATIONS ACCEPTED FOR LICENSURE guidance document 60-25 Policy On Dental Clinical Competency Examination Requirements For Licensure, effective August 5, 2021

Applicants for a Dental license (by Examination or Credential) are accepted exclusively online through our online system.

Instructions for Dental license

Reactivation application for Dentist – Revised June 2023

Reinstatement application For Dentist – Revised June 2023

Application for a Temporary Dental Permit - Revised June 2023

Form A Dentist

Form B Dentist

Form C Dentist

Employment Verification

Please use our Application Wizard for guidance on how to apply for initial licensure as a Dental Hygienist.

Applicants for a Dental Hygienist license (by Examination or Endorsement) are accepted exclusively online through our online system.

Please note: CLINICAL EXAMINATIONS ACCEPTED FOR LICENSURE guidance document 60-26 Policy On Dental Hygiene Clinical Competency Examination Requirements For Licensure, effective August 5, 2021.

Instructions for Dental Hygienist license application

Reactivation application for Dental Hygienists – Revised June 2023

Reinstatement application For Dental Hygienist – Revised June 2023

Application for a Temporary Dental Hygiene Permit - Revised June 2023

Form B Dental Hygiene

Form C Dental Hygiene

Employment Verification - Dental Hygienist

Application for Registration as a Dental Assistant II- Revised June 2023

Reinstatement application for a Dental Assistant II - Revised June 2023

Reactivation application for a Dental Assistant II - Revised June 2023

Form A Dental Assistant II - Certification of Completion of Dental Assistant Education

Form B Dental Assistant II - Experience Verification

Form C Dental Assistant II - Certification of Authorization to Perform Expanded Duties as a Dental Assistant

Employment Verification - Dental Assistant II

Application for Oral and Maxillofacial Surgeon Registration of Practice – Revised June 2023

Reinstatement of Oral And Maxillofacial Surgeon Registration – Revised June 2023

Application for Certification to Perform Cosmetic Procedures – Revised June 2023

Reinstatement of Certification to Perform Cosmetic Procedures - Revised June 2023

Deep Sedation/General Anesthesia

Application for a Permit to Administer Deep Sedation/General Anesthesia – Revised June 2023

Moderate Sedation

NOTICE: The Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students adopted by the American Dental Association in October 2016 detail the current education standards for a moderate sedation course. The October 2016 Guidelines no longer include provisions for a course to administer only by an enteral method. Any moderate sedation course taken on or after November 1, 2016 must meet the October 2016 Guidelines in order for an applicant to qualify for a conscious/moderate sedation permit in Virginia. These Guidelines must be met to qualify to administer by any method and to qualify to administer by an enteral method only. Please download the Guidelines.

Application for a Permit to Administer Moderate Sedation – Revised June 2023