Applications and Forms
ALL FEES ARE NON-REFUNDABLE & ARE REQUIRED TO BE SENT WITH THE APPLICATION
Applications for Dental Hygienist - including Advanced Procedures
New Dental Assistant Applications
Verification of Licensure Request Form
Placing my License in In-Active or Retirement Status
Professional Entity Application
New Dental Lab Application for Dentist owned Lab
New Dental Lab Application for Non-Dentist owned Lab
Dental Lab work Authorization Form
Special Volunteer License Application
Dispensing Permit Form (If you need a Controlled substance log here is an example)
Retired Volunteer License Renewal Form
Expanded Function Request Form
Anesthesia Forms-Dentists ONLY
(Forms by request only. Please email obod.board@ok.gov)
Facility Applications - There are no fees for these applications however they do require an inspection before a permit can be issued. Please read the following rules to ensure you understand the requirements for each:
Facility Anesthesia Application for Pediatric Conscious Sedation - 195:20-1-3.1(d)
Facility Anesthesia Application for Parenteral Conscious Sedation - 195:20-1-4(d)
Facility Anesthesia Application for General Anesthesia - 195:20-1-5(d)
Provider Applications - There is a $100 with these applications that must be included when submitted to the Board office. These require an inspection before a permit can be issued. Please read the following rules to ensure you understand the requirements for each:
Provider Anesthesia Application for Pediatric Conscious Sedation - 195:20-1-3.1
Provider Anesthesia Application for Parenteral Conscious Sedation - 195:20-1-4
Provider Anesthesia Application for General Anesthesia - 195:20-1-5
2023 RENEWAL APPLICATIONS--PLEASE CONTACT THE BOARD
The board office does NOT have access to user names or passwords you will need to call 405-521-2444.
If you have been expired for more than 1 year but less than 5 years you will be required to complete a reinstatement application. Please contact the Board Office for this application.
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