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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.
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.
If you are applying with the Florida
Academy of General Dentistry, please complete the appropriate forms
from above. You may submit one copy of a completed
application including all supporting documents via email as an Adobe .pdf
file, or via mail 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. 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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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
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.
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