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To apply for Program Provider approval,
please first review the criteria that
your organization must meet to be eligible. If your organization
meets these criteria, you can access the appropriate forms needed to
apply below. In order to view or print the appropriate forms you will
need
Acrobat Reader.
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Standards to Quality Continuing Education - It is recommended that
you print this document as a resource to assist you in completing the
application accurately. All questions included on the application
refer to the criteria included in this document
- It is recommended that you print this
document as a resource to assist you in completing the application
accurately. All questions included on the application refer to the
criteria included in this document - It is recommended that you print
this document as a resource to assist you in completing the
application accurately. All questions included on the application
refer to the criteria included in this document
Florida PACE Application - All organizations applying for program
provider approval with any constituent (state) organization of the
Academy of General Dentistry must complete this interactive form for approval.
Patient Protection Attachment - If your organization uses patients
during any of your courses, it is mandatory that this
form be completed and returned with your application. This applies
whether the participants or the instructor is treating or examining
the patient.
If you are applying with the Florida
Academy of General Dentistry, please complete the appropriate forms
from above. An original and four copies of these forms and all supporting documents
should be mailed to:
Florida AGD
Attn: Florida PACE Committee
2372 NW 8th Street
Delray Beach, FL 33445
An application fee of $100.00 must be
received with your application for it to be considered complete and
the review process started. Also, if the original and 4
copies (or 5 copies) of the required information are not submitted,
or no check is enclosed, your application will be returned. Your application will not be
processed until all pertinent fees are paid.
Once all fees and a completed
application is received by our state office, you will be notified
within 8 weeks of our Committees decision.
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