Forms & Fees
New - Online Licensing Database - Online Services
The Board's new online licensing database is now online and available for use. Applications, renewal, changes of address and other requests may be made online. Online payment by credit card is now available. You may access the online licensing database here.
For information about the fees charged for applications, renewals, reinstatements, verifications and other services follow this link.
Application for License/Registration/Permit
Please note: In order for CPR certification to be accepted for the purposes of initial application (and renewal), the CPR course must include a clinical, "hands-on" portion. Online-only certification courses are not acceptable pursuant to Iowa Administrative Code 650.
Most of the forms below are in PDF and require Adobe Reader to view. If you do not have Adobe Reader, you can download that software at the Adobe website. Other forms are viewable in your web browser.
Please note: applications submitted on paper may take longer to process than applications submitted electronically through the online licensing database.
Renewal Forms - 2015
|Dental Hygiene Renewal Notice Letter **Not a renewal form**||Download|
|RDH Renewal Application||Download|
|LA Renewal Application||Download|
|RDH Renewal Attachment - This form is only needed if you work in more than one location or are requesting duplicates.||Download|
|Please note: Be sure to download the correct renewal form. There are 3 types: RDA, QDA, XDA. If you fail to download the correct renewal form, your renewal may delayed.|
|Dental Assistant Renewal Notice Letter **Not a renewal form**||Download|
|RDA Renewal Application *Registered only, does NOT hold radiography qualification*||Download|
|QDA Renewal Application *Registered dental assistants with radiography qualification*||Download|
|XDA Renewal Application *For those who are NOT registered, but hold a radiography qualification (licensed nurses)*||Download|
|DA Renewal Attachment- This form is only needed if you work in more than one location or are requesting duplicates.||Download|
|Dentist Permanent License - By Examination||Download|
|Dentist Permanent License - By Credentials||Download|
|Dentist Resident License||Download|
|Dentist Resident License Extension||Download|
|Dentist Faculty License||Download|
|Dentist General Anesthesia Permit||Download|
|Dentist Moderate Sedation Permit||Download|
|Dentist Temporary Permit - Urgent Need or Education Services||Download|
|Dentist Temporary Permit to provide Volunteer Services||Download|
|Dental Hygienist Permanent License - By Examination||Download|
|Dental Hygienist Permanent License - By Credentials||Download|
|Dental Hygienist Permit for Authorization to Administer Local Anesthesia||Download|
|Dental Hygienist Temporary Permit - Urgent Need or Educational Services||Download|
|Dental Hygienist Temporary Permit to provide Volunteer Services||Download|
|Dental Assistant Trainee Status
*Please read application carefully regarding rule change*
|Dental Assistant Permanent Registration
*Please read application carefully regarding fee change*
|Dental Assistant Radiography Qualification||Download|
|Radiography Qualification Reinstatement Application||Download|