Forms & Fees
Fee Schedule
Application Forms
Miscellaneous Forms
Continuing Education Forms
Expanded Function Forms
Application for License/Registration/Permit - Online Licensing Database & Services
To make application for a license, registration or permit, please visit the Board's online licensing database. After logging in to your personal account, you may make application for a new license or renewal, submit a change of address, and make a number of other requests online. Payment may be made by credit card, or check/money order. The online shop also allows you to purchase and request a number of items online.
The average length of time for an application for license/registration to be issued, after all required items are received, is as follows:
Peak months of April - September:
Five to ten business days for all applications for license/registration.
Five to ten business days for trainees.
Non-peak months of October - March:
Three to five business days for all applications for license/registration. Three to five business days for trainees.
Please be aware of the following:
- Applications submitted on paper may take 4-6 weeks longer to process than applications submitted electronically through the online licensing database.
- Applications and other requests are not considered complete until the appropriate fee(s) have been received.
- In order for CPR certification to be accepted for the purposes of initial application and renewal, the CPR course must be a nationally-recognized course that includes a clinical, "hands-on" portion. Online-only certification courses are not acceptable pursuant to Iowa Administrative Code 650.
Fee Schedule
Application Forms
Application Forms - Dental Assistants (For use with online applications) | Online |
Application Forms - Dental Hygienists (For use with online applications) | Online |
Application Forms - Dentists (For use with online applications) | Online |
Approved Testing Sites |
Miscellaneous Forms
Change of Address/Name | Online |
Complaint Form | |
Complaint Form | Online |
Order Form - Purchase a Data List or Mailing List | |
Order Form - Trainee Manual, certificates, cards, written certification, printed copies of Board rules and Iowa Code | |
Public Health Supervision Forms | Online |
Sample Lab Prescription and Point of Origin Form | |
Sign Up for Board Notices via E-Mail | Online |
Website Feedback Form | Online |
Infection Control Inspection Form | |
IPRC Self-Report Form | Online |
Malpractice Report Form |
Continuing Education Forms
Expanded Function Forms
Out-of-State Level 1 Expanded Function Training Review Form Note: Include verification of training from the training provider with the request for review of out-of-state expanded function training. An incomplete form or lack of detail/documentation may delay a final decision by the Board. |
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Out-of-State Level 2 Expanded Function Training Review Form Note: Include verification of training from the training provider with the request for review of out-of-state expanded function training. Please include a course outline or syllabus with the request for review. |
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Request to Provide Level 1 Expanded Function Training Request Form (updated form coming soon) Note: This request is for licensees, who develop Level 1 expanded function training curriculum, so that they may train dental assistants and dental hygienists in the area of expanded functions. Training curriculum must be included with the request form. Lack of detail or supporting documentation may delay a final decision by the Board. |