Applications and Forms

* Paper renewal applications are not available online. The Georgia Board of Dentistry strongly encourages licensees to renew online. If you require a paper renewal application, please contact the office of the Georgia Board of Dentistry: (404) 651-8000.

APPLICATIONS ARE VALID FOR ONE YEAR. 

Dentistry - General 

Download this pdf file. Application for Inactive Status  

Download this pdf file. CE for Volunteer Work Reporting Form  

Download this pdf file. Dental Continuing Education Audit Form

Download this pdf file. Dental License Census Data Form

Download this pdf file. Dental Out of State Verification Form

Download this pdf file. Dental Reference Form  

Download this pdf file. Dentist Application for Faculty Licensure  

Download this pdf file. Dentist Application for Licensure by Credentials  

Download this pdf file. Dentist Application for Licensure by Endorsement for Military Spouses  

Download this pdf file. Dentist Application for Public Health Licensure  

Download this pdf file. Dentist Application for Reinstatement

Download this pdf file. Dentist Application for Licensure by Exam

Download this pdf file. Duplicate License-License Verification Order Form  

Download this pdf file. Jurisprudence Exam and Affidavit Dentist

Download this pdf file. Qualified Alien Status Form  

Download this pdf file. Volunteers in Dentistry and Dental Hygiene Application

 

Dental Hygiene 

Download this pdf file. Dental Hygiene Census Data Form

Download this pdf file. Application for Inactive Status  

Download this pdf file. CE for Volunteer Work Reporting Form  

Download this pdf file. Dental Hygienist Application for Faculty Licensure

Download this pdf file. Dental Hygienist Application for Licensure by Credentials  

Download this pdf file. Dental Hygienist Application for Licensure by Endorsement for Military Spouses

Download this pdf file. Dental Hygienist Application for Licensure by Exam  

Download this pdf file. Dental Hygienist Application for Reinstatement  

Download this pdf file. Dental Hygienist Online Application Supplement

Download this pdf file. Duplicate License-License Verification Order Form

Download this pdf file. Jurisprudence Exam and Affidavit Dental Hygienist  

Download this pdf file. Qualified Alien Status Form  

Download this pdf file. Volunteers in Dentistry and Dental Hygiene Application

 

Dentistry - Anesthesia 

Download this pdf file. Duplicate License-License Verification Order Form

Download this pdf file. Sedation Application for Deep Sedation General Anesthesia Permit  

Download this pdf file. Sedation Application for Moderate Enteral Conscious Sedation Permit  

Download this pdf file. Sedation Application for Moderate Parenteral Conscious Sedation Permit  

Download this pdf file. Sedation Notification of Additional Site-Change in Location

 

Guidelines & Information 

Download this pdf file. Fee Schedule  

Download this pdf file. Guidelines and Application for Registration of Injectables

Download this pdf file. Guidelines for General Anesthesia-Conscious Sedation Evaluation

Download this pdf file. Guidelines for Practice Closure

Download this pdf file. Secure and Verifiable Documents Under O.C.G.A. 50-36-2  

 

Education Providers

Download this pdf file. CE Provider Application for IP

Download this pdf file. Request for Review-EDDA Program Form

 

Public Health/ Health Fair

Download this pdf file. Dental Screening Application  

 

Dentistry - Injectable Pharmaceuticals

Download this pdf file. Guidelines and Application for Registration of Injectables

 

Board Order Compliance Forms

Download this pdf file. Monitoring Physician Agreement

Download this pdf file. Quarterly Self-Report Form  

Download this pdf file. Supervising Dentist Agreement  

Download this pdf file. Supervising Dentist Monthly Quarterly Report Form  

 

Board Services, Requests, or Petitions

Download this pdf file.  File Petition for Rule Variance or Waiver

Download this pdf file. Roster Request Form Dentistry  

Download this pdf file. Wall Certificate Order Form Dentistry