Get Tx Tsbde Dental Laboratory Renewal Form 2016-2025

The TX TSBDE Dental Laboratory Renewal Form is essential for maintaining the registration of your dental laboratory. This guide provides clear, step-by-step instructions to help you fill out the form accurately and efficiently online.

Follow the steps to complete your renewal form online.

1. Click ‘Get Form’ button to access the dental laboratory renewal form and open it in your preferred form editor.
2. Fill in the laboratory name, registration number, and physical address, ensuring that all fields are completed as they are mandatory.
3. Provide your contact information, including phone number and email address. Indicate whether there is an address change by selecting 'Yes' or 'No'.
4. Input details about the laboratory owner, including their name, contact information, and whether there is a new lab owner since the last renewal. Complete the mailing address fields.
5. Fill in the laboratory manager's information. If the manager is the same as the owner, you may write 'Same' in the name field.
6. Provide the name of the Certified Dental Technician of Record, note any changes, and indicate if they serve another laboratory.
7. List all individuals with ownership interest of 20% or more, providing their name, address, and type of ownership. Attach additional sheets if necessary.
8. Answer questions regarding any disciplinary actions or criminal offenses. Be prepared to provide a separate signed and notarized affidavit if you answer 'Yes' to any questions.
9. Sign and date the form, confirming compliance with the dental practice regulations in Texas.
10. After completing the form, save your changes. You have the option to download, print, or share the completed form as required.

Start the process now and ensure your dental laboratory remains compliant by submitting the renewal form online.