Get H: Home Forms Msbde Forms-site Visit-mobile Dental Units.wpd

Completing the H: HOME FORMS MSBDE Forms-site Visit-mobile Dental Units.wpd form online is essential for ensuring compliance with the Mississippi State Board of Dental Examiners. This guide will provide you with a clear, step-by-step approach to effectively filling out this important document.

Follow the steps to complete the online form accurately.

1. Click the ‘Get Form’ button to access the form and open it for editing.
2. Begin by filling in the name and permanent office address at the top of the form. Ensure the information is accurate and complete.
3. List the site visit team members in the designated field. Include the names of all individuals who will be present during the site visit.
4. Enter the date of the site visit in the specified area. Use the format MM/DD/YYYY for consistency.
5. Review the minimum requirements section carefully. Confirm that each item listed is met by your mobile or portable dental facility. Mark each requirement with a 'pass' or 'fail' as applicable.
6. For each requirement that passes, provide detailed notes or comments in the designated section if necessary, using the notes and comments area for any additional explanations or observations.
7. If this is a follow-up site visit, ensure that a certified check or money order for $150.00 is submitted as required.
8. At the end of the form, obtain required signatures from all board members and team members present. This may need to be done electronically if filling out the form online.
9. Once all sections are complete, review the form for accuracy. Make any necessary edits before proceeding.
10. After confirming that all the information is correct, you can save the changes, download the completed form for your records, print it, or share it with relevant parties.

Complete your document online today to ensure compliance with the Mississippi State Board of Dental Examiners.