License Application Forms

Instructions for completing and submitting the forms required for licensure appear below. You may also need to submit additional information (for example, examination scores). Please refer to the license requirements link on the left for complete information regarding all requirements you must meet.

Note: All forms are in Adobe Portable Document Format (PDF). To view or print these documents, you will need to have the free Adobe Reader External Link Icon installed on your computer. Download times and print quality will depend on your connection speed and printer.
Form 1 - Application for Licensure & First Registration ( PDF 23 KB)

Important Notice: A New York State professional license is valid for life unless it is revoked, annulled, or suspended by the Board of Regents. To practice in New York State your professional license must be registered. If your registration has lapsed and you need to reregister, do not submit a Form 1. Instead, contact our customer services unit to request a Delayed Registration Application by e-mailing:, or by calling 518-474-3817 Ext. 570. When e-mailing, be sure to include your profession, license number, address on record, new address (if changed), date of birth and the last 4 digits of your SSN.

ll applicants for licensure must complete this form and submit it with the $103 licensure and first registration fee directly to the Office of the Professions at the address at the end of Form 1. Make checks payable to the New York State Education Department. NOTE: Your cancelled check is your receipt.

You must answer all questions and provide all information requested unless otherwise indicated. Failure to complete all required parts of the application will delay its review. Your signature on Form 1 must be notarized by a Notary Public.

Address/Name Change Form - Optional ( PDF 20 KB)
You are required to notify us within 30 days of any name or address changes. Please read the instructions and complete the appropriate sections of this form.

Form 2 - Certification of Professional Education - (PDF 19 KB)
This form must be submitted directly by the educational institution(s) you attended. The Office of the Professions will not accept this form if submitted by the applicant.
  • Section I: Complete this section before sending the entire form to your school. Be sure to sign and date item 9.
  • Section II: The Registrar must complete this section and return all pages of the form in an official school envelope with requested documents directly to the Office of the Professions at the address at the end of the form.

Note: If you graduated from a high school in the United States, your professional school will attest to your high school/secondary education on this form. No further documentation is normally required.

However, if you completed your high school/secondary school outside the United States, you will need to document your secondary education. You must verify your secondary school diploma or graduation certificate to the Bureau of Comparative Education in one of the following ways:

  • Send the original and a photocopy by registered mail to:

    New York State Education Department
    Office of the Professions
    Division of Professional Licensing Services
    Dental Assisting Unit
    89 Washington Avenue
    Albany, NY 12234-1000

    We will return your original to you.

  • Bring your original and a photocopy in person to one of the following addresses to have the copy verified:

    New York State Education Department
    Office of the Professions
    Bureau of Comparative Education
    89 Washington Avenue, 2nd Floor
    Albany, NY 12234-1000

    New York State Education Department
    Office of the Professions
    Office of Professional Discipline
    475 Park Avenue South, 2nd Floor*
    New York, NY 10016
    *(between 31st and 32nd Streets)

Form 5 - Application for Limited Permit - (PDF 18 KB)
  • Section I: If you are applying for a limited permit, complete this section before having your prospective supervisor complete Section II. Be sure to sign and date item 9.
  • Section II: Your prospective supervisor completes this section.

Return the completed form with the $40 fee to the Office of the Professions at the address at the end of the form. If you have not already, you must also submit the Application for Licensure (Form 1), the $103 fee for licensure and first registration, and have your academic institution submit the Certification of Professional Education (Form 2) before your application for a limited permit can be approved.

Last Updated: April 18, 2016