Get H: Home Forms Msbde Application-radiology Permit.wpd

This guide provides clear instructions for completing the H: HOME FORMS MSBDE Application-radiology Permit.wpd online. Following these steps will ensure that you fill out the application accurately and thoroughly, making the submission process smoother.

Follow the steps to complete the application online:

1. Click the ‘Get Form’ button to access the document and open it in your preferred online editor.
2. Begin by entering your personal information. Fill out your first name, middle name, maiden name (if applicable), and last name. Ensure that your permanent name matches what you wish to appear on the permit.
3. Indicate your citizenship status by selecting ‘Yes’ or ‘No’. If you are not a citizen, provide your country of nationality and immigration status.
4. Enter your current email address. Note that biennial permit renewals will be managed exclusively through email correspondence.
5. Fill in your current residential address, including street, mailing address, and telephone number.
6. Provide your current office address and telephone number.
7. List the full names of all dentists with whom you work and your date of employment.
8. Include your place of birth, date of birth, age, and demographic information such as sex and race.
9. Input your social security number and details regarding your educational background, including the ADA-accredited programs you attended and your graduation dates.
10. Respond to the eligibility questions by selecting ‘Yes’ or ‘No’ and providing any necessary explanations on an attached sheet.
11. Attach required supporting documents as specified in each section, ensuring that all documentation is included in your final submission.
12. Review all information for accuracy before saving your changes.
13. Once satisfied with the completed application, download or print a copy for your records, and then share or submit the application as directed.

Complete your application online today to ensure a smooth and timely submission process.