State of Maine
Board of Dental Examiners
143 State House Station • 161 Capitol Street • Augusta, ME 04333-0143
Phone: 207-287-3333 • Fax: 207-287-8140

Forms and Applications For your convenience, we are making many forms and applications available on this site. Simply select and print the form you need, fill it out and mail to the Board of Dental Examiners. If you do not have Adobe Acrobat, you may download it by clicking on the Adobe-Get Acrobat Reader link below.

NEW!

Those forms that say fill-in form may be completed using your keyboard prior to printing, signing, and mailing. You may tab through some of the fields, however, tabbing does not always move you in the order you anticipate; using your mouse allows you to click into most fields, however certain fields (e.g. signature fields or forms to be made out by third parties) are read only fields as these need to be handwritten after printing. Those fields where you select between options (payment options, yes or no answers) are completed by using the mouse to click in the appropriate circle or box. If you hover over a field with your mouse you will be given a tip as to what the field requires. The print option is at the end of the application materials (see last page of jurisprudence exam). If you do not intend to finish the application from start to finish, you may wish to download it to your own computer before beginning. You cannot save this form to our website.

Proof of CPR certification/re-certification is required for all new dental, dental hygiene, denturist, and radiographer licensees, as well as the renewal of those same licenses. No on-line CPR courses are accepted.

You may change your contact information with the Board office via the link below:

ALMS Change of Contact Information Online Service

Dental License Application	Dental License Renewal
Denturist License Application	Denturist License Renewal
Dental Hygiene License Application	Dental Hygiene License Renewal
RDH Local Anesthesia Permit Application (Fill-in Form)	RDH Local Anesthesia Permit Renewal (Fill-in Form)
RDH Nitrous Oxide Permit Application (Fill-in Form)	RDH Nitrous Oxide Renewal
General Anesthesia/Sedation Application	Conscious Sedation Application
Expanded Function Dental Assistant Certification Application	Expanded Function Dental Assistant Certification Renewal
Public Health Supervision Reporting Form	Public Health Supervision Notification & Standing Orders Forms
Radiography License Application	Radiography Renewal (Fill-in Form)
IPDH (Ind Pract Dent Hyg)License Application (Fill-in Form)	Independent Practice Dental Hygiene Renewal
Information on Filing a Complaint	Complaint Form (Fill-in Form)

"For the protection of the health and safety of the citizens of the State of Maine"

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