Registration is mandatory to practice

Reinstatement Package Request Form

Complete and submit this form to request a reinstatement of registration package. The package will be sent by email. Please allow approximately one week for processing of your request.

 

Gender    
Full Name
Address
City

Province
Postal Code/Zip

Country
Phone Number


Email Address
 
Previous CRDHA Registration Number, if known
 
Are you currently registered to practice dental hygiene in another Canadian Province?


Name of Provincial Regulator
I am requesting a package regarding:

Additional Information