Register | Independent Dental Hygienists Canada

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Are You an Independent Practitioner?*

YesNo

Note: this information will be shared publicly

Type(s) of Hygienist Practice*

A dental hygiene clinicA mobile dental hygienist

A dental hygienist in Residential CareIndependent

EducationResearch

Public Health

Work Category*

Clinical PracticePublic Health

EducationMobile/Residential

IndependentResearch

Administration/Other

Business Name*

Hygienist First Name*

Hygienist Last Name*

Address*

City*

Province*

Postal Code*

Phone*

Fax

E-mail Address*

Website*

Which professional association are you a member of*

What Area(s) Do You Service?*

Handling Emergencies*

YesNo

What is your practice anniversary date?*

Additional Information

Account Registration

Username*

Password*

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