Forms & Fees
Fee Schedule
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.
Forms
Most of the forms below are in 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.
Applications
| Title | Form | Format |
|---|---|---|
| Dentists | ||
| 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 Hygienists | ||
| 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 Assistants | ||
| Dental Assistant Trainee Status *Please read application carefully regarding rule change* |
Download | |
| Dental Assistant Permanent Registration *Please read application carefully regarding fee change* |
Download | |
| Dental Assistant Radiography Qualification | Download | |
| Radiography Qualification Reinstatement Application | Download | |