Follow the steps to successfully fill out the Da1 Form online.

1. Click ‘Get Form’ button to access the form and open it in your preferred editor.
2. In the 'Particulars of Dentist' section, fill in your surname in BLOCK CAPITALS, followed by your full forenames. Indicate your designation (Mr, Mrs, Miss, Dr, Other) and provide your Dentist's Registration number and General Dental Council (GDC) number. Next, enter your practice address and postal code for payment processing.
3. Go to 'Part 1' which is designated for Principal and Associate Practitioners. Here, you will need to tick the relevant payment claim options such as Seniority Payments, Commitment Payments, and others listed. Provide the percentage of your earnings from dentistry attributable to Health Service gross earnings during the specified period.
4. Complete the declaration section, ensuring all declarations (i or ii) are appropriately filled out based on your role. Sign and date the form, and print your name clearly.
5. If applicable, complete 'Part 2' for your Assistant by filling in their name and GDC number, and ticking the claims for Continuing Professional Development Allowance and Practice Allowance. Again, provide the relevant percentage and complete the declaration with your signature and date.
6. In 'Part 3', your accountant needs to certify the earnings attributed to Health Service gross earnings, so ensure they sign, date, and provide their stamp in this section.
7. Once all sections are completed, review the entire form for accuracy. Save changes, and choose to download, print, or share the completed form before submission.

Complete your documents online today to ensure timely claims for your practice.