Get Dental Hygiene Program - Documentation Of Chairside Dental Assistiting Experience - Nvcc

Completing the Dental Hygiene Program documentation form is essential for applicants wishing to showcase their chairside dental assisting experience. This guide will provide clear and concise instructions to assist you in filling out the form correctly and efficiently.

Follow the steps to successfully fill out your documentation form.

1. Click ‘Get Form’ button to access the documentation form and open it in the online editor.
2. Begin by filling in your personal information. Enter your name in the 'Applicant’s Name' field. This should be your full legal name as it appears on official documents.
3. Next, input the dentist’s name in the 'Dentist’s Name' field. Ensure that you spell their name correctly.
4. Fill out the office address. Include the street address, city, state, and zip code in the respective fields.
5. Provide the office telephone number. Include the area code followed by the telephone number for easy contact.
6. In the office e-mail address section, enter a valid email that can be used for communication.
7. State your position title in the 'Applicant’s Position Title' field, describing your role within the dental office.
8. Record the dates of service. Use the provided fields to indicate the start and end month/year of your employment.
9. Indicate whether your employment was full-time or part-time. If part-time, specify the number of hours you worked per week.
10. Ensure accuracy by reviewing the information you've entered on the form. This is crucial for the verification process.
11. The dentist must certify the information provided by signing in the designated 'Dentist’s Signature' area and stamping the form with the official office stamp.
12. Lastly, ensure that the signature is dated between January 15th, 2016 and February 15th, 2016. Once everything is confirmed, save your changes.
13. You may now download, print, or share the completed form as required.

Complete your documentation form online today to ensure you meet the application requirements.