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APPLICATION FOR DENTAL HYGIENE REINSTATEMENT GEORGIA BOARD OF DENTISTRY A Division of the Georgia Department of Community Health 2 Peachtree Street, N.W. 36th Floor Atlanta, Georgia 30303 www.gbd.georgia.gov

How to fill out dental hygiene reinstatement application

Who needs dental hygiene reinstatement application?

Dental hygienists who have had their licenses suspended or revoked need to fill out a dental hygiene reinstatement application. This can happen due to disciplinary actions, failure to meet continuing education requirements, or other reasons that led to the loss of their license.

How to fill out dental hygiene reinstatement application:

1. Obtain the application form: The first step is to obtain the dental hygiene reinstatement application form. This can usually be downloaded from the licensing board's website or requested by phone or email.
2. Read the instructions: Before filling out the application, carefully read the instructions provided. This will ensure that you understand the requirements and properly complete the application.
3. Provide personal information: Start by entering your personal information in the designated fields. This includes your full name, contact information, social security number, and any other requested details.
4. Disclose previous license information: If applicable, include information about your previous dental hygiene license. This may include the license number, date of issue, and reason for suspension or revocation.
5. Include supporting documentation: Depending on the requirements of the licensing board, you may need to provide supporting documentation along with your application. This can include proof of completing any required education, certifications, or training during the period of your license suspension or revocation.
6. Explain any mitigating circumstances: If there were any mitigating circumstances that contributed to the loss of your dental hygiene license, provide a detailed explanation in the appropriate section of the application. This may include evidence of taking steps to address the issue or any rehabilitative programs completed.
7. Submit the application: Once you have completed all the necessary sections of the application and gathered any required documentation, ensure that everything is properly filled out, signed, and dated. Submit your completed application via the designated method instructed by the licensing board, whether it be online, by mail, or in person.
8. Pay any fees: In many cases, there will be associated fees for processing the dental hygiene reinstatement application. Be sure to include the required payment with your submission. The specific fee amount and payment methods will be outlined in the application instructions.
9. Follow up: After submitting your application, it is advisable to follow up with the licensing board to ensure that your application is being processed. You may need to provide additional information or respond to any requests for clarification during the evaluation process.
10. Stay informed: While waiting for the decision on your dental hygiene reinstatement application, stay informed about any updates or communications from the licensing board. This will allow you to address any additional requirements or provide any necessary documents promptly.

Remember, each state or licensing jurisdiction may have its own specific requirements for a dental hygiene reinstatement application. Therefore, it is important to refer to the instructions provided by your local licensing board when completing the application.

For pdfFiller’s FAQs

What is dental hygiene reinstatement application?

Dental hygiene reinstatement application is a form that allows individuals to restore their dental hygiene license after it has been inactive or expired for a certain period of time.

Who is required to file dental hygiene reinstatement application?

Dental hygienists who have let their license expire or become inactive are required to file a dental hygiene reinstatement application.

How to fill out dental hygiene reinstatement application?

To fill out a dental hygiene reinstatement application, individuals must provide their personal information, details on their previous license, and any required documentation or fees.

What is the purpose of dental hygiene reinstatement application?

The purpose of dental hygiene reinstatement application is to allow individuals to regain their dental hygiene license and begin practicing again.

What information must be reported on dental hygiene reinstatement application?

Information such as personal details, previous license information, continuing education credits, and any other relevant information must be reported on the dental hygiene reinstatement application.

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