CHECKLIST

ACCREDITED
175 Bloor Street East, North Tower, Suite601, Toronto, Ontario M4W 3R8
Tel: 416-961-6234 . Toll Free: 1-800-268-2346 . Fax: 416-961-6028 . www.cdho.org . registration@cdho.org

Registration Application - Checklist

¡ I Graduated from an Accredited Institution.

I have requested that my University/College send an official copy of my transcript to the CDHO.

¡ Form A – I have enclosed Form A having completed all sections and glued a passport photo on page 1.

I understand that my business address is public information and that, if I have not provided a business address, my
¡ home address will be posted to the Public Register.

¡ I have enclosed a copy of my professional liability insurance policy certificate.

Form D – I have enclosed a completed Form D which authorizes the CDHO to verify or obtain additional information
¡ respecting my application.

¡ I graduated less than 3 years ago, or I have practised dental hygiene within the last 3 years.

A Criminal Record Check obtained in Canada that is dated no earlier than one year before the date on which I expect
to be registered with CDHO. The report shows that the search was done with all names I am currently using or have
¡ ever used, including my first, middle, and last name(s), any other names listed on my legal documents, my name at
birth, or any other former or assumed names.

I have enclosed the following documents:

Proof that I am authorized to work in Canada (Canadian Birth Certificate or current Canadian Passport or Canadian
¡ Citizenship or Permanent Resident Card or valid Work Permit).

¡ Documentation supporting my name change, if applicable.

Fees: OPTION 2: $207.50 as I am registering within 12 months of graduating

¡ Online Payment: An email will be sent with payment details once your application has been approved.

¡
I have read the CDHO Registrants Resource Information which contains the Acts and Regulations pertinent to
practising dental hygiene in Ontario.

¡ I understand that I may not hold myself out as a dental hygienist in Ontario until after my application has been
approved and a certificate of registration has been issued to me.

Applicant’s Name Applicant’s Signature

Rev.: September 2023