Local Anesthesia 2025

To be eligible for enrollment individuals must:

have a current Oklahoma Dental Hygiene Licence*,
proof of Professional Liability Insurance, AND
have a CURRENT* Healthcare Provider/Professional Rescuer CPR card or eCard from an IN-PERSON testing provider (No online skills testing allowed.)

The enrollment fee must be paid in full before you will be given a spot in the course.
You will not be considered for enrollment with an incomplete application.

*Applicants from other states are welcome to apply, but it is your responsibility to find out if the course will carry over to your current state. This course is designed to meet the Oklahoma Board of Dentistry guidelines.
**If your CPR card EXPIRES BEFORE YOUR COURSE DATE, your application will NOT be accepted. Please obtain a CPR that will be valid at the time of your course before enrolling (NO EXCEPTIONS). LETTERS FROM THE INSTRUCTOR WILL NOT WORK IN PLACE OF THE CARD.

Dental assistants are NOT eligible to receive this certification in the state of Oklahoma.

Local Anesthesia

Applications will be processed in the order they are received. Spots in the course will not be secured until applications are approved. Applications with incomplete supporting documents will not be approved until corrected. Once your application has been approved and payment is received, you will receive a final confirmation email.

Course Date

Late fee begins Jul 28, 2025 (checks not postmarked before this date must include $20 late fee)

RDH License #

I am NOT seeking certification in OKLAHOMA

Applicant's Name

Mobile Number

Yes, it's okay to send me text messages including confirmations, changes, and updates. Message frequency varies. Message and data rates may apply. Reply STOP to cancel. View our terms of service & privacy policy.

We will only use your mobile number to send you a link to the course packet or to reach you outside of office hours if necessary.

Mailing Address

Employing Dentist/Office

Employer's Phone Number

Employer's Address

Profesional Liability Insurance

Browse

CPR Card Front (or both sides)

Browse

CPR Card Back (if needed)

Browse

Dental Hygiene School

School Location

School Phone Number

Dietary Restrictions

Vegetarian
Vegan
Medical/Religious

Applicant has a

Documented Learning Disability
Your official IEP must be submitted to the Oklahoma Dental Foundation NO LATER than 2 weeks BEFORE the course. Consideration will not be given if documentation is not provided 2 weeks before the course.
Language Barrier

Refund/Transfer Policy & Fees

Refunds will be granted before July 28, 2025, minus a $25 administrative fee. The course is transferable before July 28, however, there is a $25 administrative fee payable before the new applicant is enrolled or the course date is changed.

FROM JULY 28 - AUG 15, refunds will be subject to a $75 cancellation fee; transferring courses after this date will also be subject to a $75 administrative fee payable before the new applicant is enrolled or the course date is changed.

Late enrollment fees and transfer fees are non-refundable.

ALL COURSE ENROLLMENTS ARE *FINAL* THE WEEK OF THE COURSE AND ARE NON-REFUNDABLE AND NON-TRANSFERABLE.

Enrollees who fail to show to the course will not receive a refund and must resubmit their application for a future course.

All refund and transfer requests must be in writing and should be emailed to [email protected] or faxed to (405) 241-1260.

All courses are subject to change or cancellation due to Force Majeure.

ADDITIONAL ADMINISTRATIVE FEES:
•A $20 administrative fee will be imposed on all applications received after the late fee takes effect.
•Returned checks will be charged a $25 handling fee.

I have read and agree to the terms above.

Non-Discriminatory Policy Statement

It is the policy of this Foundation to provide all of its services and programs to persons of any race, religion, creed, nationality, ethnicity or color. The
Foundation shall not discriminate on the basis of race, religion, creed, nationality, ethnicity, or color in the administration of any of its programs or services.

This continuing education activity has been planned and implemented in accordance with the standards of the ADA Continuing Education Recognition Program (ADA CERP) through joint efforts between the Oklahoma Dental Association and the Oklahoma Dental Foundation.

Running Total

$1,200.00

Total

$1,200.00

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