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District of Columbia Health Professional Licensing Administration Board of Dentistry DENTAL ASSISTANT GRANDFATHERING ATTESTATION Name of Dental Assistant Applicant Place of Employment (name of office)

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What is grandfathering attestation form?

Grandfathering attestation form is a document required by regulatory authorities to confirm that certain individuals or entities are exempted from certain regulations or requirements based on their previous status or activities.

Who is required to file grandfathering attestation form?

Individuals or entities who believe they qualify for grandfathering provisions and wish to be exempted from certain regulations or requirements are required to file a grandfathering attestation form.

How to fill out grandfathering attestation form?

To fill out a grandfathering attestation form, you need to provide the required information specified in the form, such as your identification details, previous status or activities that qualify you for grandfathering, and any supporting documentation.

What is the purpose of grandfathering attestation form?

The purpose of the grandfathering attestation form is to enable individuals or entities who meet certain criteria to be exempted from specific regulations or requirements based on their previous status or activities.

What information must be reported on grandfathering attestation form?

The specific information required to be reported on a grandfathering attestation form may vary depending on the regulatory authority and the specific regulations or requirements being exempted. However, it generally includes identification details, details of previous status or activities that qualify for grandfathering, and any required supporting documentation.

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