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

Information about the fees charged for applications, renewals, reinstatements, verifications and other services is available here.


2022 Renewal Forms Forms

Completed renewal forms, which are postmarked no later than August 31, 2022 will not be subject to a late fee.  Renewal forms postmarked September 1, 2022 or later are subject to late fees.

Dental License Renewal (e.g. DDS-XXXXX) PDF
Faculty Permit Renewal (e.g. FAC-XXXXX) PDF
Sedation Permit Renewal (e.g. MS/GA-XXXXX)      PDF

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 PDF

Miscellaneous Forms

Change of Address/Name Online
Complaint Form PDF
Complaint Form Online
Order Form - Purchase a Data List or Mailing List PDF
Order Form - Trainee Manual, certificates, cards, written certification, printed copies of Board rules and Iowa Code PDF
Public Health Supervision Forms Online
Sample Lab Prescription and Point of Origin Form PDF
Sign Up for Board Notices via E-Mail Online
Website Feedback Form Online
Infection Control Inspection Form PDF
IPRC Self-Report Form PDF
Malpractice Report Form PDF

Continuing Education Forms

Approved Sponsor List Online
Continuing Education Sponsor Application PDF
Prior Approval of a Continuing Education Course PDF
Post Approval of a Continuing Education Course PDF
Sample Continuing Education Record PDF
Sample Continuing Education Record Word
Sample Attendance Record Report PDF
Application for Exemption or Extension of Continuing Education Requirements PDF

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.  Lack of detail or documentation may delay a final decision by the Board. 

PDF

Level 1 Expanded Function Training Provider Request Form

Note: Training curriculum must be included with the request form.  Lack of detail or supporting documentation may delay a final decision by the Board.

PDF

Level 2 Expanded Function Training Provider Request Form

(coming soon) 

PDF

Printed from the website on October 07, 2022 at 4:32pm.