Forms
The following applications are available in
Adobe Acrobat Format
(*.pdf). Adobe offers a free plug-in viewer on its website.
◦ Dental Anesthesia Permit Applications
Dental
Nitrous Oxide Permit Application
Enteral
Conscious Sedation Permit Application
Parenteral
Sedation Permit Application
◦ Dental Hygiene Anesthesia Permit
Applications
Dental
Hygiene Nitrous Oxide Permit Application
Local
Anesthesia Permit Application
If you have taken a local anesthesia course
outside Louisiana, and wish to apply for a local anesthesia permit, please
also fill out the affidavit below and submit it with your local anesthesia
application.
Local
Anesthesia Affidavit
◦Mobile/Portable Dental Office Permit
Applications
Mobile Dental
Office Permit Application
A mobile dental office permit will only
be issued to a Louisiana licensed dentist.
Portable
Dental Office Permit Application
A portable office permit will only be
issued to a Louisiana licensed dentist.
◦Expanded Duty Dental Assistants
EDDA
Application
◦Application for Expungement of First
Time Advertising Violations
Expungement
Application
◦DEA 224 New Application or DEA -
106 Theft or Loss Report
DEA
Forms
◦Miscellaneous Publications and Forms
HIV/HBV/HCV
Reporting Form
Approved
Radiology Course List
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