Follow the steps to complete your recertification form online.

1. Press the ‘Get Form’ button to access the recertification form and open it for editing. Make sure to save the form to your device for further completion.
2. Begin by entering your name in the designated field. Ensure that you provide your full legal name as it appears on your original certification.
3. Input your CODA certification number in the respective field. This number is essential for identifying your certification in the system.
4. Fill in your email address to receive confirmation of your recertification and any future correspondences.
5. Provide your current address, including city and zip code. If you have a new address, mark the checkbox indicating that this is a new address.
6. Enter your phone number so that the Commission can contact you if necessary.
7. Indicate the last four digits of your Social Security number in the appropriate space. This helps verify your identity.
8. Document your continuing education hours in the sections provided. You need to list the title of the course, date, sponsor, speaker, and the total hours earned. Ensure that you accumulate at least 12 hours annually.
9. Calculate the total fee based on whether your form is postmarked before or after December 31. Enter this fee at the end of the form. Remember that there is a late fee applicable if submitted after the deadline.
10. Sign and date the form in the respective fields to certify that the information provided is accurate to the best of your knowledge.
11. Prepare your payment as a check or money order made payable to the Commission Ohio Dental Assistant Certification, and keep a record of your submission.
12. Finally, save your completed form. You can choose to print it for mailing or share it digitally, ensuring you submit it before the deadline.

Complete your OH Commission Dental Assistant Certification - Recertification Form online today to ensure your certification remains current.