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http://www.dbc.ca.gov/formspubs/form_complaint.pdf
dental or medical condition and/or treatment of me (or the patient) to release to the Dental Board of Californiaor any Board representatives, related local, state and federal governmental agencies, including but not limited to, investigators and legal staff.
https://mn.gov/boards/dentistry/consumers/complaints/online-form/index.jsp
Please be sure to complete the form and press 'Submit' before exiting the page. The Board can only take action against the license of a Dentist, Dental Hygienist, or Dental Assistant license. The Board can only act against the license of individuals licensed with this Board (disciplinary or corrective action).
https://dentistry.ky.gov/Pages/Forms.aspx
Dental Hygienists General. Delegated Duty List; Verification of Licensure or Registration Form; Duplicate License or Registration Request Form; Licensure. Application for Dental Hygiene Licensure; Retirement/Reinstatement. Retirement of License Form; Application to Reinstate a Dental Hygiene License; Dental Hygiene Registration Applications
https://dentistry.ky.gov/Disciplinary-Actions/Pages/File-a-Complaint.aspx
The Complaint Process. The law requires all dental complaints to be submitted to the Board in writing and signed by the person making the complaint. Additionally, each complaint must identify the specific person or organization against whom the complaint is made.
https://www.oregon.gov/dentistry/Pages/complaint.aspx
It is also helpful to the investigatory process that you use and sign the Board's form because it assists the Board in accessing appropriate dental and medical records. A copy of the Board's Complaint Form is provided below which is a fillable PDF document which you can download, fill in, print and mail to the Board office.
https://health.maryland.gov/dental/doc/2012/complaint_form.pdf
MARYLAND STATE BOARD OF DENTAL EXAMINERS. Spring Grove Hospital Center ● Benjamin Rush Building 55 Wade Avenue Catonsville, Maryland 21228. COMPLAINT FORM PLEASE TYPE OR PRINT LEGIBLY IN BLACK OR BLUE INK. The Maryland State Board of Dental Examiners (the “Board”) regulates the practice of dentistry and dental hygiene in Maryland.
https://www.dbc.ca.gov/consumers/complaint_instructions.shtml
Please return the completed forms to the Dental Board. Note: The Authorization for Release of Dental/Medical Patient Records must be signed in order for the Board to process your complaint. For more information, please call (916) 263-2300 [email protected].
https://dentalboard.az.gov/complaint-form
Review Board Meetings, Agendas and Minutes Complaint form COMPLAINT FORM - Online submission to allow anyone the ability to file a complaint against a current Arizona dental licensee.Location: Phoenix, AZ 85007
https://floridasdentistry.gov/help-center/how-do-i-file-a-complaint/
The State of Florida's Online Resource for Dentists, Dental Hygienists, and Dental Laboratories Licensing, Renewals and Information - Florida Department of Health Florida Board of Dentistry » How do I file a complaint?-
https://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/Dentistry/Pages/default.aspx
The State Board of Dentistry, through the licensure of dentists and dental hygienists and the certification of expanded function dental assistants, insures that such individuals are suitable and qualified. The Board issues, suspends and revokes licenses and certificates.
https://www.dca.ca.gov/consumers/complaints/dbc.shtml
How to File a Complaint with the Dental Board. There are three ways that you can file a complaint: Call to have a Complaint Form mailed to you (916) 263-2300, OR; Use the On-line Complaint Form, OR; Download and Print a Complaint Form; Information Collection, Use and Access Collection and Use of Personal Information.
https://www.tn.gov/health/health-program-areas/health-professional-boards/dentistry-board/dentistry-board/complaints.html
Restorative and Prosthetic Functions Certification Courses for Dental Hygienists and Dental Assistants; Continuing Education; Licensure; Complaints; Peer Assistance; Applications; Newsletters; Legislative; Statutes And Rules; Policies; Frequently Asked Questions (FAQs) Health Professional Boards; Board of Dentistry. ... Filing Complaints and ...
https://dental.ohio.gov/Enforcement/File-a-Complaint
(Click here to be directed to local dental society) OPTION 3 A consumer may have the option of retaining an attorney for the purposes of bringing a personal injury lawsuit or other legal action against a dentist or a dental hygienist. OPTION 4 File a complaint with the Ohio State Dental Board. The Board investigates the following: 1.
https://www.ok.gov/dentistry/Applications_&_Forms/index.html
Application for Dentist/Dental Hygienist by Credential. Dental Assistants. Renewal Forms. All other forms (complaint form, name changes, verification of lic. request etc.) 2019 RENEWAL APPLICATIONS--PLEASE CONTACT THE BOARD. The board office does NOT have access to user names or passwords you will need to call 405-521-2444.
http://mn.gov/boards/dentistry/
The mission of the Minnesota Board of Dentistry is to promote and protect public health and safety; and ensure that every licensed dental professional practicing in the state meets the requirements for safe, competent and ethical practice. On our site you can apply for (or renew) a license, look up licensed dentists, and file a complaint.
https://pr.mo.gov/dental-complaint-forms.asp
Complaint Forms. IMPORTANT, PLEASE READ: The Missouri Dental Board is charged with the regulation of the dental profession in Missouri. The Board only has authority to discipline the professional license of those persons licensed by the Board. The Board does not have the authority to order a licensee to refund fees paid by a complainant...
https://gbd.georgia.gov/georgia-professional-licensure-complaint-form
Dentistry Please use the following form to submit a complaint to the Georgia Board of Dentistry. The Board investigates complaints of alleged violations of the Georgia Dental Practice Act and the Board’s rules. Please be advised that the Board does not have the authority to settle fee disputes, nor does it settle personality conflicts.
http://tsbde.texas.gov/complaints/how-to-submit-a-complaint%e2%80%8b/
Home Complaints How to Submit a Complaint Complaint Submission Procedure The processing of complaints submitted to the Texas State Board of Dental Examiners is governed by Chapter 255, Title 3, Occupations Code, and Rules 107.00 through 107.103 of the TSBDE’s Rules.
https://www.ok.gov/dentistry/
Welcome to the Oklahoma State Board of Dentistry. The mission of the Oklahoma State Board of Dentistry is to promote, protect, and provide public health and safety to the citizens of Oklahoma by regulating the practice of Dentistry, Dental Hygiene, Dental Assisting, and the fabrication of dental appliances in dental laboratories by enforcing laws, rules, and policies.
https://gbd.georgia.gov/applications-and-forms
* Paper renewal applications are not available online. The Georgia Board of Dentistry strongly encourages licensees to renew online. If you require a paper renewal application, please contact the office of the Georgia Board of Dentistry: (404) 651-8000. APPLICATIONS ARE VALID FOR ONE YEAR
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