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Practice Name Registration Application Form

Fill out the form to request approval of a practice name by the College. You can also review the College's Practice Advisory on Practice Names. Please do not use special characters (e.g. comma, underscore, brackets, or parenthesis) when filling out the form. 

We do not grant the exclusive right to use practice names. Our approval of a practice name should not be construed in any way to be a grant of the right to use such name at law.

Consult with the Ministry of Government Services and your lawyer to determine whether this name has been registered with the Ministry and/or has exclusivity secured by law. 

    For new practices, indicate date of opening. For changes of ownership, please indicate date of sale. Error : Opening Date is required
    Please list all dentists linked with this practice (owners as well as associates, even if the owner does not practice at this location).

    For each dentist, please list the RCDSO registration number after each dentist’s name; indicate whether the dentist listed is the Principal (P) dentist or an Associate (A); and if this office will be the primary office address for each of the listed dentists.

    Principal or AssociateMandatory Error : Indicate principal/associate
    Dentist's Primary AddressMandatory Error : Indicate primary/not primary
    Add Dentist
    : Indicate whether any of the dentists practice at any other location

    Your application has been submitted!

    You will receive email confirmation of your practice name application. It typically takes 15-20 business days to process applications. Thank you.

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