Dental Education Record Form

Use this form along with the Form 5R ONLY if the original dental degree was awarded from a non-accredited institution (ie. dentists from schools outside the US or Canada.). This form will be used as a preliminary review of the resident's education credentials. The Certification of Professional Education (Form 2) and official transcripts must be submitted directly to the Office of the Professions from the institution from which the dental degree was awarded, they will not be accepted if submitted by the applicant.