State of Wisconsin Department of Regulation & Licensing
Ensuring the availability of safe and competent professional services 		Secretary Celia Jackson
 Secretary Jackson
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Dentist - Application Forms

You will need to choose one of the application packet(s) listed below. Every form in the packet that you choose must be submitted if it applies to your situation.

Petitions for refunds must be in writing and may be granted only if the criteria set forth in Wis. Admin. Code s. RL 4.06 are met.


Other Information/Forms

Form #
Title
Documentation of Training Delegable Procedures to Unlicensed Person (Dental Assistant Delegation Form)
Requests for Modification of Examinations For Persons With Disabilities
Disability Modification Request Form for Examinations
Professional Verification of Request For Modification