Certified Dental Assistant

CDA
DANBs 2015 Certified Dental Assistant (CDA) exam application

packet includes applications for the following exams:
Certified Dental Assistant (CDA)

GC, RHS and ICE component exams taken in the same test administration
General Chairside Assisting (GC)

Radiation Health and Safety (RHS)
Infection Control (ICE)
RHS/ICE
RHS and ICE exams taken in the same test administration
DANB accepts 2015 exam applications through Dec. 31, 2015.
Dental Assisting National Board, Inc.

444 N. Michigan Ave., Suite 900, Chicago, IL 60611-3985
1-800-367-3262 Fax: 312-642-8507 Email: danbmail@danb.org
www.danb.org
Welcome.
Congratulations on taking the first step toward earning DANB Certified Dental Assistant (CDA) certification.
This application packet includes the exam applications for the CDA exam and the three component
exams that make up the CDA exam: Radiation Health and Safety (RHS), Infection Control (ICE) and
General Chairside Assisting (GC). Candidates may take the CDA exam (RHS, GC and ICE), take the
RHS and ICE exams at the same test administration (RHS/ICE), or take and pass the component exams
separately within a five-year period to earn certification.
There are no eligibility requirements to take the RHS and ICE exams. After passing the RHS and ICE
exams, a candidate receives a certificate of knowledge-based competency for each exam passed.
The RHS exam is recognized or required in 21 states and the District of Columbia to meet radiography
requirements. The CDA exam is recognized or required in 31 states and the District of Columbia for
either radiography or for performing expanded functions. Currently, a total of 38 states, the District of
Columbia, the U.S. Air Force and the Department of Veterans Affairs recognize or require DANB exams
for dental assisting practice.
There are eligibility requirements to take the GC or CDA exam. A candidate must be eligible under
one of three pathways. Read pages 12-13 to determine which pathway you will be eligible for and the
documentation necessary for each.
Please be sure to sign and date the application, answer the background information questions, attach
the proper documentation and include the payment. If you have any questions, please contact DANBs
Client Service Representatives at 1-800-367-3262. DANB is here to help you through the process of
earning DANB certification.
There are currently more than 36,000 proud dental professionals who maintain DANB certification!
I wish you the best as you advance in the dental assisting profession.
Sincerely,
Cynthia C. Durley, M.Ed., MBA

DANB Executive Director
2015 Dental Assisting National Board, Inc. The DANB logo is a registered trademark of the Dental Assisting National Board, Inc. (DANB). CDA, COA, CRFDA, CPFDA,CDPMA,
COMSA, DANB, and Dental Assisting National Board are registered certification marks of DANB. RHS, ICE, and Measuring Dental Assisting Excellence are registered service
marks of DANB. CERTIFIED DENTAL ASSISTANT and NELDA are certification marks of DANB. Mark of Dental Assisting Excellence is a service mark of DANB. Use of these
marks is strictly prohibited, except as provided in the Usage Guidelines for DANB Trademarks, without the express written permission of DANB.
DANB is a member of the Institute for Credentialing Excellence. The National Commission for Certifying Agencies (NCCA), an Institute for Credentialing Excellence commission with
responsibility for accrediting certification programs, has evaluated DANB national certification programs (CDA and COA), including DANB component exams (RHS,
ICE, GC and OA), and finds that DANB programs meet NCCAs highest standards, thus helping to assure validity, reliability and objectivity in the testing process.
DANB Executive Director Cindy Durley, M.Ed., MBA, completed a six-year term on the NCCA (Chair in 2003 and 2004) and five years as an Institute for Credentialing Excellence Board Director, serving as President in 2006. DANB Director of Testing and Measurement Johnna Gueorguieva, Ph.D., began her first term as an
Institute for Credentialing Excellence Board Director in 2013.
634.2 CDA 2015 Application Packet
Table of Contents
About DANB
Applying for a DANB Exam
Exam Prerequisites
Submitting an Exam Application
Payment Instructions
Background Information Policy
Military Discount
Returned Checks
Incomplete Exam Applications
Duplicate Exam Application Policy
Group Testing
Candidates With Disabilities
DANBs Nondiscrimination Policy
Retaking a Passed Exam
Scheduling a DANB Exam
Receiving the Test Admission Notice

The 60-Day Testing Window
Scheduling an Exam Appointment
Exam Appointment Confirmation
Rescheduling an Exam Appointment
Requesting a New Testing Window
Requesting a New Testing Window Due to a Missed
Exam Appointment
Requesting a New Testing Window Due to an Emergency
Canceling a Testing Window for a Partial Refund
When Pearson VUE Cancels an Exam Appointment
Taking a DANB Exam
After the Exam
Name/Address Changes
DANB Communications
Hand Scoring
Official Exam Results
Duplicate Exam Results
Duplicate Certificates
Retaking a Failed Exam
Release of Exam Results
Verification of Certificates and Certification
Conditional Certificates and Official Exam Results
Appealing a Decision
Application Statements
10
Background Information Questions
11
CDA/GC Exam Eligibility Pathways
12
CDA/GC Exam Application
14
Employer Work Experience Statement
15
RHS and ICE Exam Application
16
Exam Study Help and Reference Materials
17
Appendix A:
18
CODA-Accredited Dental Assisting Programs
7
What to Bring to the Test Center

Test Center Environment
Candidate Behavior Before, During and After an Exam
Appointment
Exam Integrity
Appendix B:
19
New Jersey-Approved Radiography Programs
Appendix C:
Maryland-Approved Radiography Programs
20
Testing with DANB: An Overview

3-4 week processing/
mailing time
{
{
{
60-day window to
schedule and take exam
2-3 weeks from

exam date
1. Candidate mails/faxes exam application, documentation and fees to DANB.

2. DANB processes candidate exam application.
3. If the application is accepted as complete, DANB mails candidate a Test Admission
Notice.
4. Candidate schedules location, date and time of exam with testing vendor Pearson VUE.
5. Candidate sits for the DANB exam. A preliminary pass/fail exam result will be provided
after completing the exam.
6. DANB mails candidate official exam results. Certificates of knowledge-based competency will be mailed upon passing the RHS and ICE exams. A CDA certificate will be
mailed if all three component exams are passed.

About DANB
DANBs Mission
Since its inception in 1948, the Dental Assisting National

Board, Inc. (DANB) has worked within and with the support
of the dental community. The American Dental Association recognizes DANB as the national certification board for
dental assistants.
DANB is a nonprofit organization. DANBs mission is to promote the public good by providing credentialing services to
the dental community.
The following organizations assist DANB in developing its

dental assisting exams by recommending subject matter
experts to DANBs exam committees:
American Board of Oral and Maxillofacial Radiology
American Dental Association
Academy of General Dentistry
American Association of Orthodontists
Organization for Safety, Asepsis and Prevention
American Academy of Oral and Maxillofacial Radiology
DANBs nine-member Board of Directors is elected by
DANB from a slate of candidates nominated by:
American Association of Dental Boards
American Dental Education Association
American Dental Assistants Association
American Dental Association
DANB certificants
The public
We accomplish and measure the success of this mission

through the creation of valid dental assisting exams; recertification requirement integrity; and valuable, visible and
accessible DANB exams, certificates of knowledge-based
competency and certifications.
We also provide testing services to the oral healthcare community, and information services and resources related to
dental assisting credentialing to support DANBs mission.
In order to accomplish these critical outcomes, DANB is
committed to a properly governed, financially secure and
administratively sound organization.
The purpose of the CDA exam is to ensure that dental assistants demonstrate entry-level knowledge-based competency
regarding tasks important to the health and safety of patients
and oral healthcare workers alike. Earning CDA certification
demonstrates that the individual meets the national standard
for knowledge in general chairside assisting, radiation health
and safety, and infection control.
Recognition of DANBs CDA Exam

DANBs CDA exam is recognized or required in 31 states,
plus the District of Columbia. DANBs CDA exam is recognized or required to perform expanded functions* in Arkansas, Georgia, Idaho, Illinois, Iowa, Maine, Maryland, Massachusetts, Minnesota, Missouri, New Hampshire, New Jersey,
New Mexico, New York, North Carolina, North Dakota, Ohio,
Oregon, Rhode Island, South Dakota, Vermont, Virginia and
Washington.
Recognition of DANBs RHS Exam

DANBs RHS exam is recognized or required in 21 states,
plus the District of Columbia, and meets state radiography
requirements in Arizona, Colorado, Connecticut, Delaware,
Indiana, Iowa, Kentucky, Maine, Maryland, Massachusetts,
Montana, New Hampshire, New Jersey, New Mexico, North
Dakota, Oregon, Pennsylvania, South Carolina, Utah, Virginia, Wyoming and the District of Columbia.
Recognition of DANBs ICE Exam

DANBs ICE exam is one component of the CDA exam and
meets state requirements for infection control* in Iowa, New
York and North Dakota.
DANB Certifications
DANB offers four national certifications:
Certified Dental Assistant CDA
Certified Orthodontic Assistant COA
Certified Preventive Functions Dental Assistant CPFDA
Certified Restorative Functions Dental Assistant CRFDA
In addition to these national certifications, DANB also offers
the following certificates of knowledge-based competency,
which allow a dental assistant to demonstrate knowledge in:
Infection Control (ICE)
Coronal Polish (CP)
Sealants (SE)
Topical Anesthetic (TA)
Topical Fluoride (TF)
Anatomy, Morphology and Physiology (AMP)
Impressions (IM)
Temporaries (TMP)
Isolation (IS)
Information and applications for COA, CPFDA and CRFDA exams can be found in separate DANB exam application packets.
Visit www.danb.org or call 1-800-367-3262.
U.S. Military and Federal Agencies Recognition

DANBs CDA exam and RHS certificate of knowledge-based
competency meet the Department of Veterans Affairs requirement for expanded duties dental assistant designation.
The Indian Health Services and all branches of the U.S.
Military encourage DANB certification. DANBs CDA exam
is approved for the GIs-to-Jobs program under the Montgomery Bill.
4
*Each states dental board implements regulations and establishes rules for delegating legally allowable duties to dental
assistants. Passing one or more of the CDA component
exams or earning CDA certification only conveys authority
to perform these duties in those states that recognize these
exams or this certification as meeting state dental assisting
requirements. This information can be found at www.danb.
org/Meet-State-Requirements.aspx.

Exam Prerequisites
The CDA exam is made up of three component exams:
RHS, ICE and GC. To earn CDA certification, a candidate
must pass all three component exams within a five-year period. The CDA component exams may be taken together or
separately. There are no eligibility requirements to take the
RHS and ICE component exams. The candidate must meet
eligibility requirements to qualify to take the CDA exam or the
GC component exam. A candidate must qualify under one of
three pathways (see pages 12-13).
Submitting an Exam Application

Exam applications can be mailed or faxed to DANB. The candidate should read this packet carefully to ensure the completed
application is submitted with all required documents and fees.
Signing and dating the application is required. By signing and dating the application, the candidate affirms that the
application and documentation are accurate and that the
candidate agrees to abide by all applicable DANB policies
described in this packet, including the Application Statements
on page 10. The signature allows DANB to release exam
results to state regulatory agencies.
Payment Instructions
DANB accepts payment by check, money order or credit card
(Visa, MasterCard, American Express or Discover). Check
or money order payments must be payable to DANB in U.S.
dollars and written in English. The application is a contract to
test, and the check or credit card authorization is the contract
to pay. The candidate should put his/her name on the check.

DANB national exam applications contain three background
information questions that all exam candidates must answer.
For details, see the Background Information Policy and Questions section (see page 11).
Military Discount
See the exam applications for active military personnel reduced exam fees. To receive the reduced fee, the candidate
must submit a letter from the commanding officer or an active
military email address (this email address will be verified by
DANB upon approval of application). If a letter is provided,
it must verify the candidates name, rank, Social Security
number, station (location) and estimated date of separation.
If documentation of active duty is not submitted, the application is considered incomplete and will be returned to the
sender. DANB will issue a refund within 30 days of notice
of the incomplete application, minus the $50 nonrefundable
application fee. Military personnel may schedule a DANB
exam at authorized Pearson VUE on-base military test centers. For on-base military test center locations, visit www.
vue.com/danb.
Returned Checks
If a candidate applies for an exam with a check that is returned
by the bank for any reason (including but not limited to nonsuf-
ficient funds, stop payment, closed account or refer to maker),

DANB will assess a $25 nonsufficient funds (NSF) fee to the
candidates account and notify the candidate. The candidate
will not be allowed to take the exam until a cashiers check
or money order for the full application and exam fee plus the
$25 NSF fee has been received. If full payment has not been
received within 30 days, the application will be null and void
and the candidates account will remain on finance hold. The
candidate must pay $75 (the $25 NSF fee and $50 nonrefundable application fee) before DANB will remove the finance hold
and process any exam application. No new business will be allowed for the candidate until the finance hold has been removed.
Incomplete Exam Applications

The candidate is responsible for submitting a complete exam
application. Incomplete applications are returned to the candidate, and a letter indicating the reasons for the incomplete
application will be sent to the candidate and the payer (if different). A refund for the exam fee, minus the $50 nonrefundable
application fee, will be sent within 30 days of notice of the
incomplete application. Refunds will be made only to the payer.
An exam application is considered incomplete for reasons
including but not limited to:
Missing information (e.g., candidate and/or payment
information, background information questions)
Appropriate documentation is not enclosed
No date or signature
Insufficient payment
Expired exam application
Duplicate Exam Application Policy

A candidate may submit exam applications to take different
component exams at any time. However, if two applications
are received for the same exam, both completed applications
will be accepted, and duplicate payments will be returned,
minus the $50 nonrefundable application fee, within 30 days,
after the payment clears.
Group Testing
Groups of four or more candidates may request to take any
DANB exams on the same day, at or around the same time.
Download the Group Testing Form from www.danb.org or
contact DANB at 1-800-367-3262 with questions.
Candidates With Disabilities

DANB exams are designed to provide an equal opportunity
for each candidate to demonstrate his/her knowledge-based
competency. The exam will be administered to best ensure
that it accurately reflects a candidates aptitude or achievement levels intended to be measured, rather than reflecting a
candidates impaired sensory, manual or speaking skills except
where those skills are factors the exam purports to measure.
DANB adheres to the provisions outlined in the Americans
with Disabilities Act. In accordance with this act, DANB will
make every reasonable effort to offer the exams in a manner
that is accessible to people with disabilities. If auxiliary aids or
alternative arrangements are required, DANB will attempt to

make the necessary provisions, unless providing such would
fundamentally alter the measurement of knowledge the exam
is intended to test, would result in undue burden, or would
provide an unfair advantage to the disabled candidate.
status, race, color, religion, national origin, sexual orientation

or disability.
To allow sufficient time to make the necessary arrangements for

modifications or auxiliary aids, the candidate must submit the
Reasonable Accommodations Request forms (found at www.
danb.org) with the required documentation and exam application, specifying exactly what aid or modification is requested by
a physician or psychologist. DANB will only accept the forms
found at www.danb.org. DANB reserves the right to authorize
the use of auxiliary aids or modifications in such a way as to
maintain the exam integrity and security. DANB exams are
administered only in the English language. Modifications will
not be approved for a candidate who requests accommodations because English is a second language. Contact DANB
at 1-800-367-3262 with questions.
DANB certificants/candidates may take and pass DANB

national certification exams (CDA, COA, CPFDA, CRFDA) or
component exams (ICE, RHS, GC, OA, CP, SE, TA, TF, AMP,
IM, TMP, IS, RF) only once. These exams may be retaken if
required for certification (the exam was passed longer than
five years ago for CDA or COA component exams or three
years ago for CPFDA or CRFDA component exams) or if directed to retake the component exam by DANB to recertify or
reinstate certification. Any certificant/candidate in violation of
this policy will have his/her application denied and returned,
and will be assessed the $50 nonrefundable application fee.
DANBs Nondiscrimination Policy

DANB does not discriminate in application, exam or certification activities on the basis of age, sex, gender identity, marital
Retaking a Passed Exam
Any DANB candidate/certificant from the state of New Mexico

who applies for the DANB RHS exam and has previously passed
the RHS exam twice within the previous 12-month period will
be in violation of this policy and will have his/her application
denied and returned, and will be assessed the $50 nonrefundable application fee.

Receiving the Test Admission Notice
DANB will send the candidate a Test Admission Notice within
three to four weeks of receiving the completed exam application. The Test Admission Notice confirms that the candidate is
eligible to take the exam and includes instructions to schedule
the exam appointment. The candidate must check the Test
Admission Notice for any of the following errors and report
them to DANB immediately at 1-800-367-3262:
The exam the candidate registered for is not the one listed
The candidates name is spelled incorrectly
The candidates ID reflects a different name than the one
used to register to test (e.g., married, maiden, hyphenated, mothers last name)
The name on the Test Admission Notice must match the ID
that the candidate will bring to the test center. The middle
name does not need to be spelled out, but the initial must
match (e.g., M on the ID and Mary on the Test Admission
Notice is acceptable and vice versa). The candidate will be
turned away from testing if the name on the ID does not match
the Test Admission Notice. The candidate would need to reapply; see the Request a New Testing Window Due to a Missed
Exam section in this packet for details.
The 60-Day Testing Window

The candidate must take the exam within the 60-day window
listed on the Test Admission Notice. Candidates who submit a
CPR card that expires before the 60-day window ends will be
given a shortened window based on the CPR expiration date.
appointment at a Pearson VUE location. To find the nearest

testing center, visit www.vue.com/danb. Appointments are
scheduled on a first-come, first-served basis. Test centers
may have limited availability. Changes to test centers may
occur without notice. DANB cannot guarantee the availability
of specific test center locations, dates or times.
Exam Appointment Confirmation

After the candidate schedules the exam appointment, he/she
will receive a confirmation via email (if the candidates email
address was included on the exam application) or regular
mail from Pearson VUE. Candidates should open and read
all email and mail from Pearson VUE. There will be important
information regarding the appointment.
Rescheduling an Exam Appointment

The candidate may reschedule an exam appointment or
extend the 60-day testing window. Regardless who paid for
an exam, only the candidate may reschedule an exam appointment. To reschedule an exam appointment within
the 60-day window, the candidate must contact Pearson
VUE. The candidate may reschedule an exam appointment
up to 24 hours before his/her scheduled exam start time at
no additional fee. See the Test Admission Notice for Pearson
VUE contact information.
Requesting a New Testing Window
Scheduling an Exam Appointment
If a candidate cannot schedule or reschedule an exam appointment before the end of his/her 60-day testing window and would
like to request a new testing window, he/she must complete
both steps below:
The candidate should schedule the exam appointment as

soon as he/she receives the Test Admission Notice. The Test
Admission Notice includes instructions to schedule the exam
STEP 1: Cancel the exam appointment: If an exam appointment has been scheduled, the candidate must cancel his/
her appointment with Pearson VUE at least 24 hours before

the scheduled exam start time. An exam appointment can be
canceled online by visiting Pearson VUEs website, www.vue.
com/danb, or by calling Pearson VUEs toll-free hot line during
normal business hours. Failure to cancel an exam appointment
will result in forfeiture of the full application/exam fees, and the
application is null and void.
STEP 2: Request a new 60-day testing window: Mail or fax
the Request a New Testing Window form to DANB within 60
days (pay $55 nonrefundable processing fee) or within 61-120
days (pay $110 nonrefundable processing fee) after the end
of your original testing window. A candidate may request a
new testing window up to two times. After the second request
for a new testing window, a current exam application with any
required documentation and full fees must be submitted.
Requesting a New Testing Window Due to a Missed

Exam Appointment
If the candidate arrives more than 15 minutes after an exam
appointment start time, the candidate will be accommodated at
the discretion of the test center administrator. If the administrator is unable to accommodate the candidate, or if the candidate
does not take a scheduled exam because the candidate missed
the appointment (for any reason except a valid emergency)
or the candidate was denied entry, the candidate may reapply for the exam with a reduced fee using the Request a New
Testing Window Due to a Missed Exam Appointment form
within 60 days of the missed exam appointment (if received
after 60 days, the candidate must reapply for the exam with
the required documentation and pay the full fees). DANB will
mail the form to eligible candidates. A candidate may request
a new testing window due to a missed exam appointment one
time. If another appointment is missed (for any reason except
a valid emergency) or the exam is not taken within the new
testing window, a current exam application with full fee must be
submitted. Contact DANB at 1-800-367-3262 with questions.
If the candidate has had an emergency, please see Request
a New Testing Window Due to an Emergency below.
Requesting a New Testing Window Due to an Emergency

If a candidate misses an exam appointment due to a personal
emergency, the candidate must submit a Request to Receive
a New Testing Window Due to an Emergency form explaining
the emergency, including supporting documents. The candidate must submit the request within 60 days of the scheduled exam date. Download the form at www.danb.org. Call
1-800-367-3262 with any questions about what constitutes
an emergency and appropriate supporting documentation.
Approved requests will receive a new 60-day testing window
at no additional fee.
Canceling a Testing Window for a Partial Refund

STEP 1: Cancel the exam appointment: If an exam appointment has been scheduled, the candidate must cancel his/
her appointment with Pearson VUE at least 24 hours before
the scheduled exam start time. An exam appointment can be
canceled online by visiting Pearson VUEs website, www.vue.
com/danb, or by calling Pearson VUEs toll-free hotline during
normal business hours. Failure to cancel a scheduled exam
appointment will result in forfeiture of the full application/exam
fees and the application is null and void.
STEP 2: Request to cancel the 60-day testing window: Mail
or fax the Request to Cancel a Testing Window form so that it is
received by DANB before the end of the 60-day testing window.
DANB will issue a refund minus the $35 cancellation fee and
$50 nonrefundable application fee (a total of $85 retained by
DANB). DANB will issue the refund to the payer.
When Pearson VUE Cancels an Exam Appointment

In the event of weather or other emergency, Pearson VUE will
attempt to notify candidates by phone of a cancellation and
will reschedule the exam appointment at no additional fee.
Taking a DANB Exam

What to Bring to the Test Center
Bring the Test Admission Notice and one form of ID. The ID must
be a currently valid, non-expired government-issued photo and
signature-bearing ID, in roman characters. A drivers license,
passport, military ID card, state ID card or U.S. governmentissued permanent resident card are all acceptable. Test centers
may use an electronic fingerprinting, palm vein and/or photographic security system for identification purposes only. Test
centers may use a video/audio recording system to enhance
exam security. The candidate must not bring any reference materials or notes into any test center area. The candidate will be
provided with an erasable noteboard and marker to use during
the exam. No visitors or unauthorized individuals will be permitted in any test center area during testing sessions.
Test Center Environment

The candidate will receive a tutorial before the exam to help
the candidate feel comfortable with the computerized format.
Time spent on the tutorial will not count as part of the exam
time period. The tutorial is not a practice test. The tutorial

describes how to mark answers. There are no breaks during
the exam. Candidates may be excused to visit the restroom,
one at a time. During the absence, the exam time clock will
continue to run. No additional time will be provided. There is no
requirement for specific clothing, but it is a good idea to wear
comfortable clothing in layers to adjust for minor fluctuations
in room temperature. It is also a good idea to wear soft-soled
shoes to allow the candidate to leave his/her seat without
disrupting others.
Candidate Behavior Before, During and After the

Exam Appointment
The behavior of each candidate taking an exam will be
monitored. Improper behavior is not acceptable before, during or after an exam appointment. DANB seeks to ensure a
fair and equitable testing experience for all individuals and
to ensure the security and reliability of the process. DANBs
Taking a DANB Exam

Disciplinary Policy & Procedures document, which is available
at www.danb.org, contains examples of improper behavior.
Exam Security
The exam is confidential. Any individual who removes or attempts to remove testing-related materials from the test center,
or who attempts to memorize, distribute or otherwise misuse an
exam, in whole or in part, in any form or by any means, verbal
or written, electronic or mechanical, for any purpose, without
the prior express written permission of DANB, will be subject
to legal action. Any candidate or certificant who engages in
improper behavior also will be subject to disciplinary action by
DANB, which may include denial or revocation of certification
or recertification. DANBs Disciplinary Policy & Procedures
document is available at www.danb.org. The test center
administrator will notify DANB of anyone who talks during the
exam, gives or receives assistance, or otherwise engages or
appears to engage in dishonest or improper behavior before,
during or after the exam. Those candidates may be required
to cease taking the exam and leave the test center.
The test center administrator will send a report to DANB
regarding the incident. After reviewing a reported incident,
DANB will determine whether there is reason to believe
that a candidate has engaged in cheating or other improper
behavior, or has otherwise violated the security of the exam.
If DANB determines that the incident report is valid, DANB
may, at its discretion, pursuant to the procedures set forth in
DANBs Disciplinary Policy & Procedures, take disciplinary
actions, including but not limited to the following:
Order the candidate to retake the exam at a time and
place to be determined by DANB
Invalidate or refuse to release the exam results of the
candidate
Deny the candidates current application for certification

Require the candidate to wait a specified period of time
before reapplying to take the exam
Revoke the candidates eligibility to sit for future exams
Take a combination of any of the above actions or other
action that DANB may deem appropriate.
If a test center administrator allows a candidate to take an

exam that the candidate is not registered for, those results
will not be valid. The original application will be considered
null and void, and the full application and exam fees will be
forfeited. The candidate will be required to reapply with a new
application, required documentation and payment of the full
exam and application fees.
Exam Integrity
To ensure a consistently high-quality testing program, each
exam is routinely reviewed for reliability and validity. Each
exam question is statistically analyzed and evaluated for
performance. A small number of pretest questions appear on
each DANB national exam. Pretest questions are new test
items that DANB includes on each exam as a way to ensure
they are accurate measures of candidate knowledge. Pretest
questions are randomly distributed throughout the exam and
are not counted in the final exam results. Since the candidate
will not know which items are pretest questions and which
are not, the candidate should answer all exam questions to
the best of his/her ability.
DANB exam committees, with final DANB Board approval,
establish passing standards (the minimum required to pass a
particular DANB exam) using standard psychometric procedures for criterion-referenced exams. A candidate is expected
to perform at or above the Board-established standard to
pass each exam.
After the Exam

Name/Address Changes
The candidate must notify DANB of address changes or
any errors in the candidates name. Call 1-800-367-3262 or
email danbmail@danb.org. A candidate must submit a Name
Change Request form and required documentation to change
a name with DANB. The form is available at www.danb.org.
DANB Communications
All communications sent to and from DANB are DANBs property. DANB cannot guarantee that communications will remain
confidential; clients have no expectation of privacy with respect
to items sent or received. DANB may disclose communications
as necessary to comply with legal processes. DANB responds
to phone and email messages within two business days.
Hand Scoring
DANB will hand score an exam on request. The candidate
must submit a Request for Hand Scoring of Exam Results
form and a $50 hand scoring fee to DANB within 30 days
after the date printed on the exam results received. The form
is available at www.danb.org. Hand scoring results of the
exam are completed within 30 days of a request. If the pass/
8
fail status is reversed as a result of the hand scoring, the

$50 fee will be refunded.
Official Exam Results

The candidate will receive preliminary results at the test center upon completing the exam. DANB presents exam results
as a pass or fail. DANB provides sub-content performance
ratings for candidates who receive a fail status, which provide useful information regarding performance in each of the
content areas on the exam. Sub-content results are rated
as high priority or average priority. Sub-content performance
ratings are a reflection on how well a candidate did in a particular content area of the exam and cannot be used in any
way to determine overall passing status. Knowledge of an
area of weakness is a useful tool to help plan for further study.
The candidate is not considered to have passed or failed an
exam until DANB generates and mails the official exam results. DANB will mail two copies of official CDA exam results;
one copy of official RHS, ICE and GC exam results; and any
earned certificates within two to three weeks after each exam
administration. Official exam results and certificates that are
returned because of an undeliverable address will be held
After the Exam

for 90 days. DANB will call the candidate to request a new
mailing address. If DANB cannot reach the candidate and the
90-day period expires, DANB will destroy the original results.
If the candidate contacts DANB with an address change after
the 90-day period, DANB will release new results after the
candidate submits a Request for Duplicate Exam Results
form and/or a Request for a Duplicate Certificate form with a
$25 fee for each request.
Duplicate Exam Results

Duplicate exam results are available for exams taken within
the last five years. The candidate must submit a Request
for Duplicate Exam Results form and the $25 fee for each
official exam result request. Official exam results older than
five years are not available, although DANB will verify certifications or certificates of knowledge-based competency
earned more than five years ago.
Duplicate Certificates
Duplicate certificates are available for $25. CDA duplicate
certificates may only be requested if the certification was
earned on June 1, 1993, or later. Because DANB provides
several opportunities for a candidate to correct errors, this
$25 duplicate certificate fee also applies for any reprint of a
certificate due to a spelling error. Download the Request for
Duplicate Certificate form at www.danb.org.
Retaking a Failed Exam

If the candidate takes the CDA exam or the RHS/ICE exam
but does not pass all of the component exams, the candidate
only needs to reapply for the failed component exam(s) with
a new application, required documentation and fees. DANB
will issue any earned certificates of knowledge-based competency. The candidate must pass all three component exams
within a five-year period to earn CDA certification. State laws
may require additional education after failed attempts. There
is no limit on how many times the candidate may take a failed
exam. Visit www.danb.org for more information.
Release of Exam Results

Exam pass/fail results will not be released to employers or
any individuals other than the candidate, except on written request of the candidate. DANB releases official exam
results or credential verifications to some state regulatory
agencies. DANB also releases aggregate results to program
directors for candidates who are graduates from or students
in the program directors dental assisting programs. If you
work out of state, please fill in your work state on the application. Failure to include out of state work information could
hinder meeting state requirements as your exam results will
not be sent to the appropriate state regulatory agency.
Verification of Certificates and Certification

DANB will verify DANB certification, RHS and ICE exam pass/
fail status and the effective date(s) of certification over the
phone to anyone on request, since these items are matters
of public record and may be disclosed. The Candidate/Certificant Request for Verification form is available at www.danb.
org. Only a candidate, certificant or employer may request
written credential verification. DANB offers verification on its

website. See the Application Statements for more details.
Conditional Certificates and Official Exam Results

In some cases, DANB may grant a conditional authorization to test to an exam candidate who answered yes to a
background information question and is in the process of
completing court or regulatory agency requirements. Not
every person who answers yes to a background information question will be placed on conditional status. Conditional status will be offered to an exam candidate only in
certain circumstances at DANBs discretion. A candidate
who has been placed on conditional status will receive an
official exam result and, if earned, a certificate marked conditional. If a person is conditionally certified or has received
a conditional certificate of knowledge-based competency or
official exam results, this means that the certification, certificate and/or results will remain valid only if certain conditions
are met in a timely manner. In many cases, the conditions
will include fulfillment of all obligations to a court of law or
regulatory agency. Full details about conditional certification
and conditional certificates of knowledge-based competency and official exam results and related processes and
procedures will be provided to each individual who is placed
on conditional status by DANB.
Use of Certification Marks and Maintaining

Certification
CDA certificants may use the CDA mark after their names
on a resume, business card, website, in a book or publication, and in other print and electronic media. A CDA certificant
may also display the mark on a nametag or uniform worn during the rendering or promoting of certified services, and on
a wall plaque present at the place where he/she renders or
promotes the certified services. If a certificant earned CDA
certification in the past but has not maintained certification,
he/she may not use the CDA mark. To remain certified, DANB
requires a minimum of 12 Continuing Dental Education (CDE)
credits annually (for those who hold one DANB certification). The requirements enhance the continued competence
of DANB certificants, and promote DANBs goal of lifelong
professional learning and development for its certificants.
In addition to the annual CDE requirement, each certificant
is required to answer Background Information Questions,
maintain DANB-accepted hands-on CPR, BLS or ACLS certification and pay the annual renewal fee. For more information, please go online to www.danb.org.
Appealing a Decision
If a candidate wishes to appeal a DANB decision regarding eligibility, administrative or exam content issues, he/she
may submit a Request for Reconsideration Under DANBs
Review and Appeal Process form and a $25 appeal fee to
DANBs Executive Director within 30 days of the date on
the DANB correspondence that prompts the candidate to
appeal (e.g., date on the letter indicating the candidates application was incomplete, date on candidates exam results).
The policy governing requests for reconsideration is available by contacting DANB at 1-800-367-3262.
Application Statements
1.
Please read the following Application Statements carefully. The Application Statements apply to all DANB national exams.
Candidates signature on the application indicates understanding and agreement to be legally bound by these statements.
I hereby apply to the Dental Assisting National Board, Inc. (DANB) for examination by DANB and issuance to me of a certificate, in accordance with and subject to the procedures and regulations of DANB. Under penalty of perjury, I declare that the information provided on my
application is true. I have read and agree to the requirements and conditions set forth in the DANB application packet covering eligibility
for and the administration of certification exams, the certification process, and DANB policies, including but not limited to the DANB Code
of Professional Conduct. I agree to disqualification from the exam, to denial of certification, and to forfeiture and return to DANB of any
certificate granted me by DANB, in the event that any of the answers or statements made by me in this application are false, or in the
event that I violate any DANB rules or regulations. I authorize DANB to make whatever inquiries and investigations it deems necessary
to verify my credentials or professional standing.
2.
I hereby release DANB, its directors, officers, examiners and agents from any and all liability arising out of or in connection with any action
or omission by any of them in connection with this application, the certification process, any exam given by DANB, any scoring relating
thereto, the failure to issue me a certificate, or any demand for forfeiture or return of such certificate, and I agree to indemnify DANB and said
persons and hold them harmless from any lawsuit, complaint, claim, loss, damage, cost or expense, including attorneys fees, arising out of
or in connection with said certification activities. I UNDERSTAND THAT THE DECISION AS TO WHETHER I QUALIFY FOR A NATIONAL
CERTIFICATION OR CERTIFICATE OF KNOWLEDGE-BASED COMPETENCY RESTS SOLELY AND EXCLUSIVELY WITH DANB AND
THAT THE DECISION OF DANB IS FINAL. Notwithstanding the above, should I file suit against DANB, I agree that any such action shall be
governed by and construed under the laws of the State of Illinois without regard to conflicts of law. I further agree that any such action shall
be brought in the Circuit Court of Cook County in the State of Illinois, or the United States District Court for the Northern District of Illinois; I
consent to the jurisdiction of such state and federal courts; and I agree that the venue of such courts is proper. I further agree that should I not
prevail in any such action, DANB shall be entitled to all costs, including reasonable attorneys fees, incurred in connection with the litigation.
3.
I understand that except as provided below, this application and any information or material received or generated by DANB in connection
with this application or the exam process will be kept confidential and will not be released unless I have authorized such release or the
release is required by law. I understand that DANB will verify receipt of any DANB exam application and the date received, on request.
I further understand and agree that DANB may also provide verification to anyone by phone, by mail or on DANBs website regarding
whether I hold any DANB certifications, including the Certified Dental Assistant (CDA), Certified Preventive Functions Dental Assistant
(CPFDA), Certified Restorative Functions Dental Assistant (CRFDA), Certified Orthodontic Assistant (COA), Certified Dental Practice Management Administrator (CDPMA), or Certified Oral and Maxillofacial Surgery Assistant (COMSA) certifications; any DANB certificates of
knowledge-based competency, including Radiation Health and Safety (RHS), Infection Control (ICE), Coronal Polish (CP), Sealants (SE),
Topical Anesthetic (TA), Topical Fluoride (TF), Anatomy, Morphology and Physiology (AMP), Impressions (IM), Temporaries (TMP), and
Isolation (IS); and any state-specific certificates administered by DANB on behalf of a state regulatory body, including the Arizona Radiologic Proficiency certificate, Arizona Coronal Polishing certificate, Oregon Radiologic Proficiency certificate, Oregon Expanded Functions
Dental Assistant certificate and Oregon Expanded Functions Orthodontic Dental Assistant certificate. Phone and mail verification will be
provided to anyone upon request and will consist of oral or written confirmation of whether I hold any of the DANB-administered credentials
listed above and the effective dates for each credential. Online verification through DANBs website may consist of online display of my
name, the DANB-administered credentials I hold and dates earned, current DANB certification status, and my city and state of residence.
My full address will not be posted online by DANB. I further understand and agree that DANB may, from time to time, provide my name
and address along with the names and addresses of certificants and those holding DANB certificates of knowledge-based competency to
dentists interested in hiring a DANB individual from their area, and to providers of continuing education opportunities. I further understand
that this consent will remain in effect unless and until I submit a written request to have this information omitted from release. I understand
that if I want to opt out of the online verification process, then I must submit a written request for omission of this information to the following address: DANB Communications Department, 444 N. Michigan Ave., Suite 900, Chicago, IL 60611.
4.
I understand that by providing my email address on the application form, I am consenting to receive email messages from DANB and its
affiliates related to their products and services or news affecting the dental assisting profession. I understand that DANB agrees not to
provide my email address to any third party without my consent, and that I can request removal from DANBs email distribution list by following the directions contained in the Privacy Policy section of DANBs Terms and Conditions of Use of DANB.org, located at www.danb.org.
5.
I authorize DANB to release my exam results to state regulatory agencies. Individuals cannot opt out of DANB release of exam results
to state regulatory agencies. I also authorize DANB to use information from my application and exam(s) for statistical analysis, providing
that any personal identification is deleted.
6.
I understand that I can be disqualified from taking or continuing to sit for an exam, from receiving exam results and from obtaining certification if DANB determines through proctor observation, statistical analysis or any other means that I was engaged in collaborative, disruptive
or other unacceptable behavior during the administration of or following the exam.
7.
I understand that the content of all DANB exams is proprietary and strictly confidential information. I hereby agree that I will not disclose,
either directly or indirectly, any question or any part of any question from the exam to any person or entity. I understand that the unauthorized receipt, retention, possession, copying or disclosure of any DANB exam materials, including but not limited to the content of any
exam question, before, during or after the exam may subject me to legal action. Such legal action may result in monetary damages and/
or disciplinary action including voiding exam results and denial or revocation of certification.
8.
I understand that for each application submitted, DANB will process the appropriate payment. If I fail to show up for an exam for which I
have applied, and there is no documented DANB-accepted emergency, and I failed to comply with DANB cancellation policies, I am still
obligated to pay the full exam fee. I further understand that taking the exam and then revoking payment constitutes the wrongful use of
DANB products and services and I may be subjected to legal action. I am obligated to pay for the exam whether I pass or fail. I agree not
to dispute the exam fee. Passing candidates will not be eligible to retain their exam results if the exam fee is not paid in full.
10
Revised 10/1/12
Background Information Policy and Questions

DANB national exam applications contain three background information questions that all exam candidates must answer.
These questions require the DANB national exam candidate to disclose if he/she has had any felony convictions within the
last five years or is currently serving a sentence for a felony conviction; has ever been disciplined by a regulatory, certifying
or examination agency; has ever been investigated or dismissed by an educational institution for cheating or another ethical
violation; or has ever been declared mentally incompetent by a court of law. DANB will review each response and make a
determination, in consultation with legal counsel, on a case-by-case basis. DANB reserves the right, under extraordinary
circumstances, to bring individuals for review under DANBs Disciplinary Policy & Procedures.
Background Information Questions

The candidate must answer each question in the box in the background information section on the exam application. Failure to answer the background information questions will result in an incomplete application.
1.
Is your answer yes to either of the following?

In the last five years, have you been convicted of, or pled guilty or no contest to, a felony or any crime punishable
by confinement in a state or federal prison for any length of time?
Are you currently serving a sentence of confinement, home detention, parole, probation, or other court-ordered
supervision, or are you subject to a reporting requirement (e.g., sex offender or violent offender registry) in connection with a felony conviction, including for any conviction that occurred more than five years ago?
It is not necessary to report misdemeanor convictions. If you are uncertain whether a conviction was for a felony or a misdemeanor, you must mark yes.
2.
Have you ever been the subject of any of the following:

Suspension, revocation, or voluntary surrender of your dental assisting license, registration, or other state-recognized dental assisting credential?
Suspension, revocation, or voluntary surrender of a license, registration, or other state-recognized credential in
any profession?
Loss of authorization to practice dental assisting or any profession as an employee of the federal government?
Loss of authorization to practice dental assisting or any profession in a jurisdiction that does not require registration, licensure, or other recognized employment credential?
Disciplinary action by a professional regulatory board, certifying or examination agency, or other professional body?
Investigation by or dismissal from an educational institution for cheating or any other ethical violation?
3.
Have you ever been declared mentally incompetent by a court of law?
Documentation Required if a Candidate Answers Yes

If a candidate answers yes to any background information question, he/she must attach a signed and dated personal
statement describing the circumstances surrounding each occurrence, the offense or reason for the conviction or disciplinary action, the date of the adverse action, the penalties imposed, and the dates when penalties for each occurrence were
or will be completed.
The candidate must also provide official documentation related to each occurrence, as described in more detail below:
For felony convictions (i.e., a yes answer to the first question), documentation may include a true copy of every
police report, judgment of conviction, sentencing order and termination of probation order, if applicable; documents
should show the offense underlying each conviction, the date of conviction, the penalties imposed by the court and
evidence that all of the requirements imposed by the court were completed. Any person being held on criminal charges or serving a sentence of confinement, including prison, jail, home detention, or an equivalent mode of confinement,
for any offense, must be fully released from confinement before applying for and/or taking a DANB exam or before
renewing or reinstating DANB certification.
For regulatory, credentialing or educational disciplinary action (i.e., a yes answer to the second question), documentation may include a true and official statement from the disciplining agency or educational institution describing
the offense and penalties imposed and, if applicable, providing evidence of completion or expiration of all penalties,
including reinstatement of license or credential.
For a court declaration of mental incompetence (i.e., a yes answer to the third question), documentation may include
true copies of all relevant court orders and related documents.
11
CDA and GC Exam Eligibility Pathways

CDA and GC Pathway I
CDA and GC Pathway II
1. Graduation (or anticipated graduation) from a Commission on Dental Accreditation (CODA)-accredited

dental assisting or dental hygiene program or current
Registered Dental Hygienist (RDH) license
Required Documentation
For graduates:
Enter the CODA-accredited program code number (see
pages 18-19) on the application.
Enclose a photocopy of the candidates certificate of
completion/diploma or official transcript (transcript may
not be a copy). Document must show proof of program
completion. A letter from a CODA-accredited dental
assisting program on school letterhead indicating the
candidates name and date of graduation, signed and
dated by the program director, will also be accepted.
1. High school graduation or equivalent
For students scheduled to graduate within 90 days after application to test:

Submit an Intent to Graduate letter that must include:
Students name
Date the program director anticipates the student will
complete the dental assisting program (must be dated
within 90 days of anticipated graduation date)
Program directors signature and date signed
Must be on school letterhead
Official exam results and certificates will be held by DANB
for all candidates who submit an Intent to Graduate letter as
proof of anticipated graduation, until required proof of graduation has been received by DANB. Once the exam is taken,
the DANB Graduation Documentation for Pathway I form
(available at www.danb.org) will be mailed to each candidate
who submitted an Intent to Graduate letter. Program directors
are required to notify DANB in writing should any student
for whom this statement was provided fail to graduate. If a
candidate fails to submit the required documentation within
90 days from the testing date, GC exam results will become
invalid, and RHS and ICE exam results and certificates of
knowledge-based competency will be mailed to the candidate,
if applicable.
For Registered Dental Hygienists:
Enclose a photocopy of the candidates RDH license (accepted from any state except Alabama). Must be current
at the date of application and exam.
2. Current Cardiopulmonary Resuscitation (CPR), Basic
Life Support (BLS) or Advanced Cardiac Life Support
(ACLS) from a DANB-accepted provider; must be
current at the date of application and exam.
q Enclose front and back copy of a valid, DANB-accepted hands-on CPR, BLS or ACLS card (see page 13).
For high school eligibility in the U.S. and Canada:
q Enclose a photocopy of the candidates high school
diploma, GED certificate or official transcript (transcript
may not be a copy) indicating graduation (high school or
GED institution must be a recognized school in the U.S.
education system), or official state agency graduation
verification of high school graduation; or proof of college
or postsecondary coursework at an institution accredited
by a U.S. Department of Education-recognized agency.
Official documents must include a school seal, school
stamp indicating the document is official. For U.S. high
school education verification, contact the state board of
education. Any cost of such independent verification shall
be the responsibility of the candidate. No other documentation will be considered.
For high school eligibility outside the U.S. and Canada:
Enclose a photocopy of the candidates high school diploma or a photocopy of transcript with graduation date
or a photocopy of the postsecondary degree/college
transcript and a photocopy of the document translation.
Enclose an official equivalency report from an independent, DANB-accepted evaluator in a sealed envelope
from the evaluator. If the equivalency report arrives with
the application and is not in a sealed envelope from the
evaluator, the application will be returned, minus the $50
nonrefundable application fee.
An international graduate must submit his/her education
credentials for evaluation to one of these DANB-accepted
providers: National Association of Credential Evaluation Services (www.naces.org) or the American Association of Collegiate Registrars and Admissions
Officers (ies.aacrao.org) at 202-296-3359, ext. 4600, or
ies@aacrao.org. All costs shall be the responsibility of
the candidate. DANB will return all original international
documents to candidates.
2. Minimum of 3,500 hours work experience as a dental
assistant, accrued over a period of at least two years
to a maximum of four years; employment must be
verified by a licensed dentist.
q Enclose a completed Employer Work Experience Statement found on page 15. Dental assisting experience
gained outside the United States/Canada may be used
to qualify to take a DANB exam.
(ACLS) from a DANB-accepted provider; must be current at the date of application and exam.
q Enclose front and back copy of a valid, DANB-accepted
hands-on CPR, BLS or ACLS card (see page 13).
12
CDA and GC Exam Eligibility Pathways

CDA and GC PATHWAY III
1. Status as a former DANB CDA certificant or
Graduation from a CODA-accredited D.D.S. or
D.M.D. program or
Graduation from a dental degree program outside
the U.S. or Canada
For former DANB CDA Certificants:
q Enter the candidates DANB certification number on the
application. For DANB certification number, call DANB
at 1-800-367-3262.
For graduates of a CODA-accredited D.D.S. or D.M.D. program in the U.S. or Canada:
q Enclose a photocopy of the candidates diploma, certificate of completion or dental license.
For graduates of a D.D.S. or D.M.D. program outside the
U.S. and Canada:
q Enclose a photocopy of the candidates dental school
transcript and the translation OR a photocopy of a diploma and the translation, OR a photocopy of a current
dental license and the translation.
q All non-English language documents must be translated into English and a copy of the document translation
submitted with your application. Translation does not
have to be official.
(ACLS) from a DANB-accepted provider; must be
current at the date of application and exam.
q Enclose front and back copy of a valid, DANB-accepted
hands-on CPR, BLS or ACLS card (see next column).
CPR, BLS or ACLS: Required Documentation

For All CDA/GC Exam Eligibility Pathways
CPR, BLS or ACLS must be current (not expired) at the time
the candidate applies and takes the exam. A candidate who
submits a CPR, BLS or ACLS card that expires before the
60-day testing window will be given a shortened window
based on the CPR, BLS or ACLS expiration date.
Enclose a photocopy of the candidates current, signed CPR,
BLS or ACLS card (front and back) from one of the organizations listed below. The card must be dated and signed or
imprinted with the instructors name and also have the candidates name or signature on the card. The course must include
CPR, and a hands-on exam must be taken. An exemption will
be allowed if a candidate submits a letter from a physician
verifying that the individual has a permanent disability that
prevents achievement of accepted CPR.
DANB only accepts CPR, BLS or ACLS from the providers
below, and only if the course included CPR and a hands-on
exam is taken. CPR, BLS or ACLS from other providers will
not be accepted, and exam applications will be returned as
incomplete.
DANB-Accepted CPR, BLS and ACLS Providers
American Environmental Health and Safety

American Heart Association
American Red Cross (card or certificate accepted)
American Safety and Health Institute
Canadian Red Cross
Emergency Care and Safety Institute
Emergency First Response
Emergency Medical Training Associates
Emergency University*
EMS Safety Services
Medic First Aid
Military Training Network
National Safety Council (Green Cross)
ProCPR*
Saudi Heart Association
* Not all courses include the hands-on exam, so check

with the provider before taking the course to be sure it
will be accepted by DANB.
13
2015 Certified Dental Assistant (CDA) or General Chairside Assisting (GC) Exam
This 2015 application will be accepted through Dec. 31, 2015.
After Dec. 31, 2015, download a 2016 application packet from www.danb.org.
Please indicate which exam you would
like to take. Check only one box.
1.
It is the responsibility of the candidate to ensure that this application is signed and dated,
the background information questions are answered, and all required documentation
and fees are included and submitted to DANB. Incomplete applications will be returned
with a refund minus the $50 nonrefundable application fee.
2.
Mail or fax completed application and supporting documents to DANB. Checks must
include candidates name.
q CDA exam
(GC, RHS, ICE exams taken together)
q GC exam only
Signature and Date
Must be signed and dated or the application will be returned as incomplete.
I hereby affirm that my answers to all questions are true and correct, I have met all eligibility requirements, and I will comply with all DANB policies and procedures. I further affirm that I have read
and understood the Application Statements contained on page 10, and I intend to be legally bound by them. I understand that the $50 application fee is not refundable under any circumstances.
Signature X____________________________________________ Date X____________________________
Background Information
All three questions in this section must be answered or application will be returned as incomplete.
Read the questions in their entirety on page 11. Failure to answer all three questions will result in the application being returned as incomplete.
If you checked Yes for any question, make sure to include required documentation.
No 2. Regarding having ever been disciplined by a
No 3. Regarding ever being declared
No 1. Regarding felony convictions within the
Yes
last five years or sentences currently being

served for felony convictions
Yes
regulatory board, certifying or examination

agency or educational institution
Candidate Information
Yes
mentally incompetent by a court of

law
Must be filled out completely or application will be returned as incomplete.
I am a U.S. citizen. q Yes q No Non-U.S. citizens will be provided a temporary number by DANB in lieu of a Social Security #.
Candidates SS#
I work in a state different than the one in which I reside. q Yes q No If yes, what state:_____
__ __ __-__ __ -__ __ __ __
English is the language I speak at home. q Yes q No
I work in a dental office. q Yes q No
I work in a dental office that uses: q digital radiography q automatic processing q manual processing (check all that apply)
(Please type or print with a pen.)
Name (must match your ID exactly)_______________________________________________________________________________

Last
First
Middle Name or Initial
Prior Name (if applicable)____________________________________ Email______________________________________________

Home Address___________________________________________ City________________________ State________Zip_________
Phone Numbers: Office(___)_______________ Home(___)_______________ Cell(___)_______________ Fax(___)_______________
Eligibility Pathway Information
Complete documentation must be attached or application will be returned as incomplete.
q Pathway I
Program code ____________ (see Appendix A)
q Pathway II
Total dental assisting work experience _____/_____ (years/months)
q Pathway III
DANB CDA certification # __
Employed in MD or NJ ONLY
State Approved School ID #
__ __ __ __
__ __ __ __ __
(see insert)
Complete documentation must be attached or application will be returned as incomplete. Select the eligibility pathway
and provide the appropriate supporting information. Include CPR card copy (front and back) for all pathways.
Payment Information
For office use only. CDA (3605) GC (3635)
Candidates Name_________________________________________________ Candidates SSN ___ ___ ___ - ___ ___ - ___ ___ ___ ___
q Traditional candidate:
CDA exam fee: $375
q Employed in Maryland:
CDA exam fee: $395
q Active military personnel: CDA exam fee: $350
GC only: $200
GC only: $200
GC only: $195
CDA exam (3605)

GC exam (3635)
q Check/Money Order (payable to the Dental Assisting National Board, Inc. or DANB)
q Credit Card Authorization (VISA, Mastercard, Discover & American Express accepted): Amount $_____________
Credit Card Number
__ __ __ __
__ __ __ __
__ __ __ __
__ __ __ __
CVV __
__ __
Expiration Date __ __/__ __
Cardholders Name___________________________________________ Cardholders Signature X_________________________________________

Cardholders Billing Address_______________________________________________ City________________________________________________
State__________________________ Zip _________________________ Daytime Phone number (_______)__________________________________
By signing, the cardholder acknowledges intent to register for the aforementioned DANB exam in the amount of the total shown hereon and agrees to perform the obligations set forth in the cardholders
agreement with the issuer. Furthermore, the cardholder understands that the signature obtained at the exam administration shall be used to indicate receipt of purchase. A candidate who fails to show up for
the exam for which he/she registered and has not canceled the exam as described in this packet is still required to pay for the exam. (See the Application Statements for further requirements.)
Mail: DANB 444 N. Michigan Ave., Suite 900 Chicago, IL 60611

Questions? 1-800-367-3262 or www.danb.org
14
OR
Fax: 312-642-8507
Do not fax twice or you will be charged twice.
Revised 10/1/12
2015 Employer Work Experience Statement (CDA/GC ExamPathway II)

This 2015 Employer Work Experience Statement will be accepted through Dec. 31, 2015.
Please print clearly with a pen. The form must be filled out completely or the application will be returned as incomplete.
Name of Dental Practice _______________________________________ Office Phone ___________________________

Address ______________________________________ City _______________________ State _____ Zip ___________
Name of Licensed Dentist _______________________________________________ Lic # ________________________
A licensed dentist (license will be verified by DANB staff), from any country, can assess the work experience of a dental assistant in the country that the
verifying dentist supervised/trained the dental assistant for whom he/she is completing a DANB Work Experience Statement.
Name of Exam Candidate (Assistant): __________________________________________________________________

I hereby attest that the above named candidate has worked a minimum of 3,500 hours as a dental assistant, accrued over
at least two years and a maximum of four years. I am verifying all employment even if the candidate has worked for other
dentists in prior years.
Dates candidate has been in my employment:
From __________________ To ___________________

include month and year
Dates of previous employment:
From __________________ To ____________________

If an assistant has worked as a dental assistant for more than one dentist during the required time period, the candidate may attach a letter on office letterhead from all dentists worked for during the time period. Each letter must be signed and dated by the dentist and include the dentists license number,
the month and year the assistant began and ended employment, if the assistant was employed full or part time and that the assistant worked as a dental
assistant. This form must be completed by at least one of the candidates current or former employers and included with the application. DANB will accept
multiple work experience statements in lieu of letters from former employers.
By signing this form, I further attest that I have personally trained or can verify that the candidate has been trained in the following areas. During the tenure of employment, if this candidate has not performed all of these functions in the office, he/she
must still possess a basic understanding of them in order to increase his/her likelihood of success on the exam. If the candidate
has not been trained in or has not demonstrated basic knowledge of all areas listed below, he/she is not eligible to sit for the
exam and should not apply to take this exam until these functions have been performed or knowledge has been demonstrated.
X __________________________________________________
Signature of Licensed Dentist
3 Preliminary examination of patients
(intraoral and extraoral)
3 Charting teeth/completing treatment
documentation
3 Using diagnostic aids
(such as radiographs and
impressions for study models)
3 Taking and recording patients vital
signs
3 Four-handed dentistry techniques

3 Preparation and understanding of
armamentarium
3 Performing and assisting with
intraoral procedures
3 Managing patients
3 Processes and procedures for the
laboratory
X ______________________________
Date
3 Use, handling and characteristics
of dental materials
3 Providing oral health patient
education
3 Office operations (inventory,
ordering, equipment maintenance
and legal)
3 Preventing/managing dental/medical emergencies
This form is part of the documentation required for CDA/GC application under Pathway
II. Please see pages 12-13 for additional documentation required.
15
2015 Radiation Health and Safety (RHS) Exam,

Infection Control (ICE) Exam or RHS/ICE Exam
This 2015 application will be accepted through Dec. 31, 2015.
After Dec. 31, 2015, download a 2016 application packet from www.danb.org.
Check the exam you would like to take.
q RHS exam
q ICE exam
q RHS/ICE exam
1.
It is the responsibility of the candidate to ensure that this application is signed and dated,
the background information questions are answered, and all required documentation
and fees are included and submitted to DANB. Incomplete applications will be returned
with a refund minus the $50 nonrefundable application fee.
2.
Mail or fax completed application to DANB. Checks must include the candidates name.
(RHS and ICE exams taken together)
Signature and Date
Must be signed and dated or the application will be returned as incomplete.
I hereby affirm that my answers to all questions are true and correct, I have met all eligibility requirements, and I will comply with all DANB policies and procedures. I understand that if this exam (or exams
on the RHS/ICE application) complete(s) the requirements to earn CDA or COA certification, I attest to holding a current DANB-accepted hands-on CPR, BLS or ACLS card. I further affirm that I have
read and understood the Application Statements contained on page 10, and I intend to be legally bound by them. I understand that the $50 application fee is not refundable under any circumstances.
Signature X____________________________________________ Date X____________________________
Background Information
All three questions in this section must be answered or application will be returned as incomplete.
Read the questions in their entirety on page 11. Failure to answer all three questions will result in the application being returned as incomplete.
If you checked Yes for any question, make sure to include required documentation.
No 2. Regarding having ever been disciplined by a
No 3. Regarding ever being declared
No 1. Regarding felony convictions within the
Yes
last five years or sentences currently being

served for felony convictions
Yes
regulatory board, certifying or examination

agency or educational institution
Candidate Information
Yes
mentally incompetent by a court of

law
Candidates SS#
I am a U.S. citizen. q Yes q No Non-U.S. citizens will be provided a temporary number by DANB in lieu of a Social Security #.
I work in a state different than the one in which I reside. q Yes q No If yes, what state:_____
__ __ __-__ __ -__ __ __ __
English is the language I speak at home. q Yes q No
I work in a dental office. q Yes q No
I work in a dental office that uses: q digital radiography q automatic processing q manual processing (check all that apply)
(Please type or print with a pen.)
Name (must match your ID exactly)_______________________________________________________________________________

Last
First
Middle Name or Initial
Prior Name (if applicable)____________________________________ Email______________________________________________

Home Address___________________________________________ City________________________ State________Zip_________
Phone Numbers: Office(___)_______________ Home(___)_______________ Cell(___)_______________ Fax(___)_______________
Education/Experience Information
This information is optional. No documentation required.
For our records, please indicate your education/experience.

q CODA-accredited program (dental assisting/hygiene)
See Appendix A for program codes.
Graduation year/Anticipated graduation year ________
Program code ________
q On-the-job-trained dental assistant
Years of experience _____/_____ (years/months)
q U.S. D.D.S./D.M.D. or international dental degree
q Previous DANB certificant: Prior DANB certification number ___ ___ ___ ___ ___ ___
q Non-CODA-accredited program (dental assisting/hygiene) See www.danb.org for program codes.
Graduation year/Anticipated graduation year ________
Program code ________
Payment Information
Employed in MD or NJ ONLY
State Approved School ID #
__ __ __ __
(see insert)
RHS (3625) ICE (3630) RHS/ICE (3616)

For office use only.
Candidates Name_________________________________________________ Candidates SSN ___ ___ ___ - ___ ___ - ___ ___ ___ ___
RHS only: $175
q Traditional candidate:
RHS only: $195
q Employed in Maryland:
q Active military personnel: RHS only: $170
ICE only: $175

ICE only: $175
ICE only: $170
RHS/ICE exam fee: $250

RHS exam (3625)

ICE exam (3630)
RHS/ICE exam (3616)
q Check/Money Order (payable to the Dental Assisting National Board, Inc. or DANB)
q Credit Card Authorization (VISA, Mastercard, Discover & American Express accepted): Amount $_____________
Credit Card Number
__ __ __ __
__ __ __ __
__ __ __ __
__ __ __ __
CVV __
__ __
Expiration Date __ __/__ __
Cardholders Name___________________________________________ Cardholders Signature X_________________________________________

Cardholders Billing Address_______________________________________________ City________________________________________________
State__________________________ Zip __________________________ Daytime Phone number (______)__________________________________
By signing, the cardholder acknowledges intent to register for the aforementioned DANB exam in the amount of the total shown hereon and agrees to perform the obligations set forth in the cardholders
agreement with the issuer. Furthermore, the cardholder understands that the signature obtained at the exam administration shall be used to indicate receipt of purchase. A candidate who fails to show up for
the exam for which he/she registered and has not canceled the exam as described in this packet is still required to pay for the exam. (See Application Statements for further requirements.)
Mail: DANB 444 N. Michigan Ave., Suite 900 Chicago, IL 60611
16 Questions? 1-800-367-3262 or www.danb.org

OR
Fax: 312-642-8507
Do not fax twice or you will be charged twice.
Revised 10/1/12
Exam Study Help and Reference Materials

CDA Exam Blueprints
100 multiple-choice items

1 hours testing time
Sub-Content Areas
Expose and evaluate
Quality assurance and radiology regulations
Radiation safety for patients and operators
Infection control
Please visit www.danb.org to download exam blueprints.

All exam items are coded to the exam blueprint.
Review the exam blueprint
Familiarize yourself with the terminology presented
Assess your knowledge regarding all content areas
Reference Materials
Please visit www.danb.org to download the exam references
suggested by the DANB exam committees. These references
can be obtained through sellers, libraries or online.
Certified Dental Assistant (CDA) Exam

The CDA exam consists of 320 multiple-choice items and
is made up of three component exams: GC, RHS and ICE.
The candidate must meet minimum performance standards
on each component exam to earn a CDA certification.
General Chairside Assisting (GC)

Sub-Content Areas
Collection and recording of clinical data
Chairside dental procedures
Chairside dental materials (preparation,
manipulation, application)
Lab materials and procedures
Patient education and
oral health management
Prevention and management of emergencies
Office operations
% on exam
10
45
9
% on exam
26
21
31
22
Infection Control* (ICE)

Sub-Content Areas
% on exam
Patient and dental healthcare
10
worker education
Prevent cross-contamination and disease transmission 20
Maintain aseptic conditions
10
Perform sterilization procedures
15
Environmental asepsis
15
Occupational safety
30
*References 2003 CDC Guidelines for Infection Control in
Dental Health-Care Settings and Occupational Safety and
Health Administration (OSHA) Standards
4
10
12
10
Prepare for DANB Exams

The DALE Foundation,
the official DANB affiliate,
offers interactive online
e-learning courses and
study aids to help you
prepare for DANB exams,
refresh your knowledge,
and earn continuing education credits.
To learn more or to
purchase a course, visit
www.dalefoundation.org.
Featured Promotion
17
Appendix A: CODA-Accredited Dental Assisting Programs

Dental assisting educational programs accredited by the Commission on Dental Accreditation (CODA), as of August 2014, are listed below. Candidates who are students or graduates of any of these programs should mark the number of the program and year of graduation in the spaces
provided on the application. For the most up-to-date list of CODA-accredited dental assisting programs, go to www.danb.org. If the candidates
CODA-accredited dental assisting program is not listed, please call 1-800-367-3262.
0753
0754
0346
0822
0864
0790
ALABAMA
Calhoun Comm. Coll.
Faulkner State Community College
Fortis College
Lawson State Comm. Coll.-Bessemer
Trenholm State Technical College
Wallace State Community College
0501
ALASKA
University of Alaska-Anchorage
0503
0743
0605
ARIZONA
Phoenix College
Pima County Community College
Rio Salado College
0255
0505
ARKANSAS
Arkansas Northeastern College
Pulaski Technical College
0511
0514
0515
0534
0506
0523
0838
0536
0745
0518
0516
0517
0776
0257
0259
0261
0270
0528
0721
0529
0532
0512
0535
0538
0804
0250
0722
0540
0502
CALIFORNIA
Cerritos College
Chaffey Community College
Citrus College
City College of San Francisco
College of Alameda
College of Marin
College of the Redwoods
College of San Mateo
Contra Costa College
Cypress College
Diablo Valley College
Foothill College
Hacienda LaPuente Adult Ed.
Heald College-Concord Campus
Heald College-Hayward Campus
Heald College-Stockton Campus
Moreno Valley College
Orange Coast College
Palomar Community College
Pasadena City College
Sacramento City College
San Diego Mesa College
San Jose City College
Santa Rosa Junior College
COLORADO
Front Range Comm. Coll.-Larimer
IntelliTec Medical Institute
Pickens Technical College
Pikes Peak Community College
Pueblo Community College
0823
4001
0549
0591
0533
0839
0170
0550
0852
0551
0531
0805
0688
0555
0915
0554
0530
0609
0723
FLORIDA (cont.)
Eastern Florida State College
Florida State College at Jacksonville
Gulf Coast State College (day)
Gulf Coast State Coll. (online weekend)
Hillsborough Community College
Indian River State College
Lincoln Technical Institute-Fern Park
Lindsey Hopkins Technical Ed. Ctr.
Lorenzo Walker Inst. of Technology
Manatee Technical Institute
Northwest Florida State College
Orlando Technical Center
Palm Beach State College
Pinellas Technical Education Center
Robert Morgan Educational Center
Santa Fe Community College
South Florida State College
Tallahassee Community College
Traviss Career Center
0895
0894
0965
0557
0258
0262
0914
0901
0966
0908
0610
0962
GEORGIA
Albany Technical College
Athens Technical College
Atlanta Technical College
Augusta Technical College
Columbus Technical College
Georgia Northwestern Tech. College
Gwinnett Technical College
Lanier Technical College
Ogeechee Technical College
Savannah Technical College
Southern Crescent Technical College
Wiregrass Georgia Technical College
0265
0785
HAWAII
Heald College-Honolulu Campus
University of Hawaii Maui College
0932
0559
0561
0755
0891
0562
0724
0979
0543
0885
0875
0545
CONNECTICUT
A. I. Prince Technical High School
Lincoln College of New England
Tunxis Community College
Windham Technical High School
0178
0778
0907
0251
0877
0504
FLORIDA
Atlantic Technical Center
Broward Community College
Charlotte Tech. Center
College of Central Florida
Daytona State College
D.G. Erwin Technical Center
18
0725
0729
0794
0574
0647
0254
0572
0795
0986
0857
0573
0577
0579
0993
0581
0582
0583
0756
0727
0260
0584
IOWA
Des Moines Area Comm. College
Hawkeye Community College
Indian Hills Community College
Iowa Western Community College
Kirkwood Community College
Marshalltown Community College
Northeast Iowa Comm. College
Scott Community College
Vatterott College-Des Moines Campus
Western Iowa Tech Comm. Coll.
0585
0987
0602
0587
KANSAS
Flint Hills Technical College
Labette Community College
Salina Area Tech. School
Wichita Area Technical College
0902
0881
0846
KENTUCKY
Bluegrass Comm. & Tech. Coll.Leestown Campus
West Kentucky Tech. College
MAINE
University of Maine Augusta/
University College of Bangor
0988
MARYLAND
Hagerstown Community College
0596
0598
0601
0184
0769
0600
0726
0606
MASSACHUSETTS
Massasoit Community College
McCann Tech. School
Middlesex Community College
Mount Wachusett Community College
Northern Essex Community College
Quinsigamond Community College
Southeastern Technical Institute
Springfield Technical Comm. Coll.
ILLINOIS
Elgin Community College
Illinois Valley Community College
John A. Logan College
Kaskaskia College
Lewis and Clark Comm. College
0171
0655
0608
0612
0758
0611
0780
0619
0824
MICHIGAN
Baker College-Auburn Hills
Baker College-Port Huron
Delta College
Grand Rapids Community College
Lake Michigan College
Mott Community College
Northwestern Michigan College
Washtenaw Community College
Wayne County Comm. College
INDIANA
C4 Columbus Area Career
Connection/Ivy Tech. State
Indiana Univ. School of Dentistry
Ind. U. Sch. of Dentistry-distance
Indiana Univ. Northwest-Gary
Indiana Univ.-Purdue Univ.-Ft. Wayne
International Business College
Ivy Tech Comm. College-Anderson
Ivy Tech Comm. College-Kokomo
Ivy Tech Comm. College-LaFayette
Ivy Tech Comm. College-South Bend
Kaplan College
University of Southern Indiana
0620
0747
0648
0728
0734
0622
0882
0621
0760
0759
0626
0748
0623
MINNESOTA
Central Lakes College
Century College
Dakota County Technical College
Hennepin Technical College
Herzing University
Hibbing Community College
Minneapolis Comm. & Tech. College
Minnesota West Comm. & Tech. Coll.
Minn. St. Comm & Tech Coll.-Moorhead
Northwest Tech. College-Bemidji
Rochester Community & Tech. Coll.
St. Cloud Technical College
South Central Tech. College-Mankato
IDAHO
Carrington College of Boise
College of Western IdahoCosponsor of Boise State University
Appendix A: CODA-Accredited Dental Assisting Programs

0627
0266
0671
MISSISSIPPI
Hinds Community College
Meridian Community College
Pearl River Community College
0166
0854
0629
0935
0936
MISSOURI
Missouri College
Nichols Career Center
Ozarks Tech. Community College
Metropolitan Com. Coll.-Penn Valley
St. Louis Comm. College-Forest Park
0633
0816
MONTANA
Montana State Univ.-Great Falls
Salish Kootenai College
0634
0172
0637
0636
0635
0798
NEBRASKA
Central Community College
Kaplan College
Metropolitan Community College
Mid-Plains Community College
Southeast Community College
Vatterott College-Omaha Campus
0969
0859
NEVADA
College of Southern Nevada
Truckee Meadows Comm. College
0719
NEW HAMPSHIRE
NHTI, Concords Community College
0252
0860
0691
0617
0893
0761
0542
0787
5008
0546
0967
0735
0646
0656
0650
0692
0267
0651
0652
0750
0167
0653
0981
0201
4100
0268
0783
NEW JERSEY
Burlington County Inst. of Tech.
Camden County College
Cape May County Tech. Institute
Cumberland Cty. Tech. Ed. Center
Fortis Institute
Rutgers University, School of Health
Related Professions
NEW MEXICO
Central NM Community College
Dona Ana Comm. College
Luna Community College-Las Vegas
Santa Fe Community College
University of New Mexico-Gallup
NEW YORK
Monroe Community College
SUNY Educ Opportunity Ctr.-Buffalo
NORTH CAROLINA
Alamance Community College
Asheville-Buncombe Tech. Comm.
Coll.
Cape Fear Community College
Central Carolina Community College
Central Piedmont Community College
Coastal Carolina Community College
Fayetteville Technical Comm. College
Forsyth Technical Comm. College
Guilford Technical Comm. College
Martin Community College
Miller-Motte College
Miller-Motte College-Raleigh
Montgomery Community College
Rowan-Cabarrus Community College
0654
0928
0657
0658
0921
NORTH CAROLINA (cont.)

Univ. of N. Carolina Schl. of Dentistry
Wake Technical Community College
Wayne Community College
Western Piedmont Comm. College
Wilkes Community College
0659
NORTH DAKOTA
North Dakota State Coll. of Science
0896
0661
0176
0994
0175
OHIO
Choffin Career and Technical Center
Eastern Gateway Community College
Fortis College-Cuyahoga Falls
Herzing University-Akron
Miami-Jacobs Career College
0188
0736
0828
0887
0271
OKLAHOMA
Francis Tuttle Technology Center
Metro Tech. Center, Health Careers
Center
Moore Norman Technology Center
Rose State College
Western Technology Center
0663
0737
0664
0665
0632
0668
OREGON
Blue Mountain Comm. College
Central Oregon Comm. College
Chemeketa Community College
Lane Community College
Linn-Benton Community College
Portland Community College
0263
0869
0918
0870
0834
0738
PENNSYLVANIA
Bradford School
Harcum College
Harrisburg Area Comm. College
Luzerne Cty. Community College
Manor College
Westmoreland County Comm. Coll.
0675
PUERTO RICO
University of Puerto Rico, College of
Health Related Prof.
0676
0624
RHODE ISLAND
Comm. College of Rhode Island
Lincoln Technical Institute
0926
0678
0680
0964
0677
0683
0681
0682
0888
SOUTH CAROLINA
Aiken Technical College
Florence-Darlington Tech. Coll.
Greenville Technical College
Horry-Georgetown Tech. College
Midlands Technical College
Spartanburg Community College
Tri-County Technical College
Trident Technical College
York Technical College
0684
SOUTH DAKOTA
Lake Area Technical Institute
0685
0607
0625
0884
0686
TENNESSEE
Chattanooga State Comm. Coll.
Concorde Career College-Memphis
Kaplan College-Nashville
Northeast State Tech. Comm. Coll.
Tennessee Coll Applied Tech-Knoxville
0982
0687
0739
0848
TENNESSEE (cont.)
Tennessee Tech Center-Dickson
Tennessee Tech Center-Memphis
Tennessee Tech Center-Murfreesboro
Volunteer State Comm. College
0695
TEXAS
Coleman Coll. of Health Sciences
Del Mar College
El Paso Community College
Grayson County College
San Antonio College
Medical Education and Training
Campus-Air Force Dental Asst. Prog.
Texas State Tech. Coll.-Waco
0740
0974
UTAH
Davis Applied Technology College
Ogden-Weber Applied Tech. College
0919
VERMONT
Center for Technology-Essex
2011
0991
0995
0762
VIRGINIA
Fortis College-Richmond
Germanna Community College
Northern Virginia Community Coll.
J. Sargeant Reynolds Comm. Coll.
0702
0703
0704
0904
0927
0980
0707
0710
WASHINGTON
Bates Technical College
Bellingham Technical College
Clover Park Technical College
Lake Washington Tech. College
Renton Technical College
Seattle Vocational Institute
South Puget Sound Comm. College
Spokane Community College
0975
WEST VIRGINIA
Mercer County Tech. Ed. Center
0889
0690
0811
0730
0693
0694
0853
0858
0713
0717
0718
0996
WISCONSIN
Blackhawk Technical College
Fox Valley Technical College
Gateway Technical College
Northeast Wisconsin Tech. College
Western Tech. College
Wisconsin Indianhead Technical
College
0900
DENTAL HYGIENE
All CODA-accredited Dental Hygiene
Programs
19
Appendix B: New Jersey-Approved Radiography Programs

New Jersey Approved Radiology Schools and Programs for Dental Assistants
2165
Advantage Career Institute
2169
Harris School of BusinessVoorhees
2117
American InstituteClifton
2321
Institute for Continuing Education/Dental Studies
2167
American InstituteToms River
2160
Institute for Health Education (Dental Assisting)
2102
Atlantic County Institute of Technology
2311
Middlesex County College
2319
Brookdale Community College
2118
Monmouth County Vocational School
2151
Burlington County Institute of Technology
2401
Morris County Vocational School
2318
Camden County College
2324
NJ Health Professionals Development Institute
2109
Cape May County Technical School
2101
NJ School of Dental Assisting Forked River
2140
Central Career School
2106
Ocean County Voc-Tech School (Adult Education)
2133
Cumberland County Tech. & Voc. E. Ctr.

(Dental Assisting)
2315
Ocean County Voc-Tech School (day)
2162
Quality Dental School of Technology
2168
D.A.S. of Ocean County

2159
Raritan Valley Community College
2141
Dental Assistant Services

2131
Rutgers Univ, School of Health Related Professions
2132
Everest InstituteSouth Plainfield

2108
Technical Institute of Camden County
2144
Fortis InstituteLawrenceville (Dental Assisting)

2145
Warren CCC Ctr. for Career & Personal Development
2170
Fortis InstituteLawrenceville (Radiology Only)
2104
Fortis InstituteWayne (Dental Assisting)
2116
Fortis InstituteWayne (Radiology Only)
2400
20
All other programs*

*This includes closed schools and schools not located in New Jersey
Appendix C: Maryland-Approved Radiography Programs

Maryland Approved Schools and Programs for Dental Assistants
0432
All State Career Academy
0430
Allegany College of Maryland
*0400
Allegany Community College (Cumberland)
0439
American Health Career Institute
0424
Anne Arundel Community College (Arnold)
0403
Baltimore City Community College (Baltimore)
*0416
The Carolyn Ianaro Radiology Course (Berlin)
0429
*0401
Carroll Community College (Westminster)

Community College of Baltimore County
0420
Center of Applied Technology, Edgewater (Edgewater)
0402
Chesapeake College Center for Allied Health (Easton)
0422
College of Southern Maryland (LaPlata)
0428
DATS (Bethesda)
*0407
Educational Horizons, Inc. (Bethesda)
0404
Essex Community College/The Community College of Baltimore County (Baltimore)
0410
Dr. James A. Forrest Career and Technology Center (Leonardstown)
0408
Fortis Institute (Towson)
*0405
Frederick Community College (Frederick)
*0419
Frederick County Dental Society (Frederick)
0436
Hands On Dental Assisting Training
0425
Hagerstown Community College (Hagerstown)
0406
Harford Community College (Bel Air)
*0417
Howard Community College (Columbia)
0414
Hygiene Associates (Bethesda)
0427
Kaplan College (formerly Hagerstown Business College) (Frederick)
0438
Maryland Dental Assistant School
0421
Maryland State Dental Association (Columbia)
*0411
Montgomery College (Takoma Park/Silver Spring)
0423
Prince George Community College (Largo)
0426
RH Dental Education Concepts (Bethesda)
0412
Southern Maryland Dental Society (College Park)
0431
TESST College (Towson)
*0413
University of Maryland Dental School (Baltimore)
0437
Vivien Thomas Medical Arts Academy
0415
Wor-Wic Technical Community College (Salisbury)
*Schools no longer provide courses, but received prior Maryland Board Approval.
21
DANB Executive Director

Cynthia C. Durley, M.Ed., MBA
Patricia Capps, CDA, RDH, M.S.

Joanne Dawley, D.D.S.
D. Bradley Dean, D.D.S., M.S.
Linda Golodner, B.A.
Katharine Noble, BSNH, CDA, RDA, HMC (FMF),
U.S. Navy
Denise Romero, CDA, RDA, M.A.
Secretary
Mary Harrison, CDA, EFDA, EFODA, FADAA
Vice Chair
Carol Oeder, CDA, COA, CPFDA, CRFDA,
CDPMA, FADAA, LPN
Chair
Frank A. Maggio, D.D.S.

444 N. Michigan Ave., Suite 900
Chicago, IL 60611-3985
1-800-367-3262
www.danb.org

Certified Dental Assistant

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CDA

DANBs 2015 Certified Dental Assistant (CDA) exam application

Certified Dental Assistant (CDA)

General Chairside Assisting (GC)

DANB accepts 2015 exam applications through Dec. 31, 2015.

Dental Assisting National Board, Inc.

Cynthia C. Durley, M.Ed., MBA

634.2 CDA 2015 Application Packet

Applying for a DANB Exam

Scheduling a DANB Exam

Receiving the Test Admission Notice

Taking a DANB Exam

After the Exam

Background Information Questions

CDA/GC Exam Eligibility Pathways

CDA/GC Exam Application

Employer Work Experience Statement

RHS and ICE Exam Application

Exam Study Help and Reference Materials

What to Bring to the Test Center

Testing with DANB: An Overview

2-3 weeks from

1. Candidate mails/faxes exam application, documentation and fees to DANB.

634.2 CDA 2015 Application Packet

Dental Assisting National Board, Inc.

Since its inception in 1948, the Dental Assisting National

The following organizations assist DANB in developing its

We accomplish and measure the success of this mission

Recognition of DANBs CDA Exam

Recognition of DANBs RHS Exam

Recognition of DANBs ICE Exam

U.S. Military and Federal Agencies Recognition

634.2 CDA 2015 Application Packet

Applying for a DANB Exam

Submitting an Exam Application

Background Information Policy

ficient funds, stop payment, closed account or refer to maker),

Incomplete Exam Applications

Duplicate Exam Application Policy

Candidates With Disabilities

Applying for a DANB Exam

status, race, color, religion, national origin, sexual orientation

To allow sufficient time to make the necessary arrangements for

DANB certificants/candidates may take and pass DANB

DANBs Nondiscrimination Policy

Retaking a Passed Exam

Any DANB candidate/certificant from the state of New Mexico

Scheduling a DANB Exam

The 60-Day Testing Window

appointment at a Pearson VUE location. To find the nearest

Exam Appointment Confirmation

Rescheduling an Exam Appointment

Requesting a New Testing Window

Scheduling an Exam Appointment

The candidate should schedule the exam appointment as

634.2 CDA 2015 Application Packet

Scheduling a DANB Exam

Requesting a New Testing Window Due to a Missed

Requesting a New Testing Window Due to an Emergency

Canceling a Testing Window for a Partial Refund

When Pearson VUE Cancels an Exam Appointment

Taking a DANB Exam

Test Center Environment

time period. The tutorial is not a practice test. The tutorial

Signature X________________ Date X

Prior Name (if applicable) Email__________

Total dental assisting work experience _/_ (years/months)

Expiration Date /

Cardholders Name___ Cardholders Signature X_

Name of Dental Practice _____________ Office Phone _

From To _

From To __