Skip to Main Content
State of Nevada Seal Nevada State Board of Dental Examiners
State Agencies State Jobs ADA Assistance
  Home
  • Home
    HomeState of NevadaNevada Governor
  • Consumers
    ConsumersFrequently Asked QuestionsLicense VerificationComplaint FormHealth Care Records Statutes and RegulationsGoverning LawsHelpful Links
  • Licensure
    LicensureApply for a LicenseDental AssistantsLicensee Resources
  • Business Services
    Business Services
  • Public Info
    Public InfoPublic MeetingsNews & Press ReleasesPublic SafetyAdvisory Opinions2023 Legislative Session in ReviewEvent CalendarTechnical Bulletins
  • About
    AboutMission StatementBoard MembersStaff
  • Contact
    ContactStaffState HolidaysPetition the BoardJob Opportunities
  • Home
    • State of Nevada
    • Nevada Governor
  • Consumers
    • Frequently Asked Questions
    • License Verification
    • Complaint Form
    • Health Care Records Statutes and Regulations
    • Governing Laws
    • Helpful Links
  • Licensure
    • Apply for a License
    • Dental Assistants
    • Licensee Resources
      • Licensee FAQ's
      • Continuing Education
      • Infection Control
      • Change of Address
      • Current Licensee Change of Address
      • Licensee Forms
      • Moderate Sedation & General Anesthesia Permit and Site Permit Applications
      • Dental Hygiene Public Health Endorsement
      • Board Approved Certification Programs/Courses
      • Advisory Opinions
      • Current Schedule of Fees
      • Helpful Links
      • Special Health Endorsement
      • Dental Hygiene License Renewal 2024
      • COVID-19
  • Business Services
    • Business Services
  • Public Info
    • Public Meetings
    • News & Press Releases
    • Public Safety
    • Advisory Opinions
    • 2023 Legislative Session in Review
    • Event Calendar
    • Technical Bulletins
  • About
    • Mission Statement
    • Board Members
    • Staff
  • Contact
    • Staff
    • State Holidays
    • Petition the Board
    • Job Opportunities

Licensee Forms

  • Notification of Name Change Form
  • Notification of Address Change Form
  • Reactivation Application for Inactive/Retired License Form
  • Voluntary Surrender
  • Infection Control Initial Inspection Request Form
  • Infection Control Inspection/Survey Form (09/2023)
  • Local Anesthesia Permit Application (Hygiene Only)
  • Nitrous Oxide Permit Application (Hygiene Only)
  • Public Health Endorsement Application Form (Hygiene Only)
  • Request for Advisory Opinion Form
  • Exam / License Verification Order Form
  • Purchase Order & Credit Card Payment Form
  • General Anesthesia / Deep Sedation Inspection and Evaluation Form
  • Moderate Sedation Inspection and Evaluation Form
  • Prescription Monitoring Program Annual Self Query
    The Official State of Nevada Website | Copyright ©2019 State of Nevada - All Rights ReservedPrivacy PolicyADA Technology Accessibility GuidelinesWeb Style StandardsADA AssistanceState ADA Website
    Version