Get De Application For Unrestricted Permit 2017-2025

Filling out the DE Application For Unrestricted Permit online is a crucial step for dental professionals seeking to administer anesthesia safely and legally. This guide provides you with clear and comprehensive instructions on navigating each section of the application, ensuring you complete it accurately and efficiently.

Follow the steps to complete your application smoothly.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Select the type of permit you are applying for by checking the appropriate box: 'Unrestricted Permit - Individual' or 'Unrestricted Permit - Facility'.
3. Enter your Delaware Dental License Number in the provided field.
4. Fill in your identifying and contact information including your name, other names used, date of birth, gender, social security number status, phone number, and email address.
5. Provide details about the location where sedation or anesthesia will be administered, including the office address and verifying the necessary operating and safety equipment.
6. Answer each item regarding the equipment and personnel available to handle emergencies during procedures.
7. If applying for an Unrestricted Permit - Individual, select your qualifications based on the criteria set forth and provide supporting documentation.
8. If applying for an Unrestricted Permit - Facility, enter the anesthesiologist's information and arrange for the necessary documentation to be sent to the Board.
9. Review all disclosures and report any relevant information as required.
10. Sign and date the affidavit section to certify the accuracy of the information provided.
11. Submit the completed application along with the required fee and supporting documents, ensuring all sections are signed and notarized.
12. After submission, allow 4-6 weeks for processing before receiving your permit.

Complete your DE Application For Unrestricted Permit online to ensure compliance and enhance your practice.