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 NamesPlease 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 Error : Opening Date is required
    Please list the full names of all dentists practicing 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

    : 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 10-15 business days to process applications. Thank you.
    Something went wrong with the submission.
    Please correct the ${amount} error(s) detected below.