Forms & Fees


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
For information about the fees charged for applications, renewals, reinstatements, verifications and other services follow this link.


Renewal Forms

To avoid late fees, renewal forms must be completed by August 31, 2021 at 11:59 p.m. if completed electronically via the online services website.  If submitting a paper renewal, it must be completely filled out and postmarked by August 31.  Renewals completed or postmarked September 1, 2021 or later will be subject to late fees.  Incomplete paper renewals may be returned and subject to a late fee.

If you need help to reset your online services account password or require other assistance related to user account after normal business hours, please email OCIO.ServiceDesk@iowa.govor call 515-281-5703 or 800-532-1174.  Please note: The OCIO service desk only has access to user account system and will be unable to assist you with issues related to renewal or application after you've logged into the online services website.  Please forward those questions to IDB@Iowa.gov.

Renewal Type

Format

RDH Renewal PDF
LA Renewal PDF
QDA Renewal (Registration & Radiography Qualification) PDF
RDA Renewal (Registration Only) PDF
XDA Renewal (for Nurses) PDF

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
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
Prior Approval of a Continuing Education Course PDF
Post Approval of a Continuing Education Course PDF
Prior Approval for Expanded Functions Training PDF
Expanded Functions Documentation Form - DA Online
Sample Expanded Functions Documentation Form - DA PDF
Expanded Functions Documentation Form - RDH Online
Sample Expanded Functions Documentation Form - RDH PDF
Sample Expanded Functions Documentation Form - Level 1 PDF
Sample Continuing Education Record PDF
Sample Continuing Education Record Word
Continuing Education Sponsor Application PDF
Sample Attendance Record Report PDF
Application for Exemption or Extension of Continuing Education Requirements PDF

Forms
Most of the forms above are in PDF and require Adobe Reader to view. If you do not have Adobe Reader, you can download that software at the Adobe website. Other forms are viewable in your web browser.   

Printed from the website on September 16, 2021 at 10:14pm.