Section 12.28.937. Dental hygienist licensure by credentials.

	(a)  The board will issue a license by credentials to practice dental hygiene under this section to an applicant who meets the requirements of AS 08.32.014, 08.32.030, and this section.  
	(b)  An applicant for license under this section shall submit to the department  
		(1) a complete, notarized application on a form provided by the department;  
		(2) the applicable fees established in 12 AAC 02.190;  
		(3) an authorization from the applicant for release of the applicant's records to the department;  
		(4) an affidavit from the applicant that lists the license number and the name of the jurisdiction for all dental hygiene licenses that the applicant holds or has ever held in any jurisdiction; and  
		(5) copies of certificates showing the applicant has completed 30 hours of continuing education during the three years immediately preceding the date of application as required under 12 AAC 28.410.  
	(c)  In addition to the requirements of (a) and (b) of this section, an applicant for a license under this section shall arrange for and ensure the submission of the results of a level II Professional Background Information Services (PBIS) credentials review conducted by PBIS, sent directly to the department from PBIS. The credential review must include  
		(1) a copy of a current certification in cardiopulmonary resuscitation (CPR) techniques for the applicant that meets the requirements of 12 AAC 28.920;  
		(2) a copy of the applicant's certificate of examination that meets the requirements of AS 08.32.014(a)(1)(C);  
		(3) as required under 12 AAC 28.908(a), a statement from the applicant certifying the applicant will adhere to the ethical standards specified in 12 AAC 28.905(a);  
		(4) an affidavit from the applicant documenting that during the five years immediately preceding application  
			(A) the dates and locations where the applicant has practiced dental hygiene;  
			(B) that the applicant has been in active clinical practice documenting at least 2,500 hours for five years immediately preceding application;  
		(5) if the applicant is or has ever been employed as a dental hygienist with a federal agency, verification of the current status and disciplinary history from each federal agency where the applicant is or has been employed;  
		(6) verification of the applicant's status and complete information regarding any disciplinary action or investigation taken or pending from all licensing jurisdictions where the applicant holds or has ever held a dental hygiene license;  
		(7) affidavits from three licensed dentists or licensed dental hygienists stating the applicant has been in active clinical practice documenting at least 2,500 hours during the five years immediately preceding application.  
	(d)  In addition to the requirements of this section, an applicant for a dental hygiene license must document completion of the jurisprudence examination prepared by the board, covering the provisions of AS 08.32,  AS 08.36,  and this chapter relating to the practice of dental hygiene, with a passing score of at least 70 percent.  

Authorities

08.32.014;08.32.030;08.32.070;08.36.070

Notes

Authority

AS 08.32.014 AS 08.32.030 AS 08.32.070 AS 08.36.070 Editor's note: An application for a Professional Background Information Services (PBIS) credential review under 12 AAC 28.937 may be obtained from Professional Background Information Services, 23460 North 19th Avenue, Suite 225, Phoenix, AZ 85027; telephone: [phone].

History

Eff. 1/22/2004, Register 169; am 5/5/2006, Register 178; am 12/5/2009, Register 192; am 12/15/2013, Register 208; am 3/11/2016, Register 217

References

12.28.937