The Board proposes the rule amendment to modify and adopt changes to the list of approved forms; incorporate the rules by reference into the rule; and list the website address where the forms can be obtained.

DEPARTMENT OF HEALTH
Board of Dentistry

RULE NO: RULE TITLE
64B5-1.021: List of Approved Forms; Incorporation
PURPOSE AND EFFECT: The Board proposes the rule amendment to modify and adopt changes to the list of approved forms; incorporate the rules by reference into the rule; and list the website address where the forms can be obtained.
SUMMARY: The rule amendment will modify and adopt changes to the approved forms; incorporate the rules by reference into the rule; and list the website address where the forms can be obtained.
SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS: No Statement of Estimated Regulatory Cost was prepared. The Board determined that small businesses would not be affected by this rule.
Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.
SPECIFIC AUTHORITY: 466.004 FS.
LAW IMPLEMENTED: 120.52(15) FS.
IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE SCHEDULED AND ANNOUNCED IN FAW.
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Sue Foster, Executive Director, Board of Dentistry/MQA, 4052 Bald Cypress Way, Bin #C08, Tallahassee, Florida 32399-3258

THE FULL TEXT OF THE PROPOSED RULE IS:

64B5-1.021 List of Approved Forms; Incorporation.

The following forms used by the Board in its dealings with the public are listed as follows and are hereby adopted and incorporated by reference, and can be obtained from the Board of Dentistry’s website at http:/www.doh.state.fl.us/mqa/dentistry/ the Board office at 4052 Bald Cypress Way, Bin # C08, Tallahassee, Florida 32399-3258:

(1) Application for Dental Examination/Dental Hygiene Examination, DH-MAQ 1182 (Revised 9/11/08) DPR/DN/003-(Rev. 2/94), effective 8-19-97;

(2) Application for Reactivation for an Inactive Florida Dental/Dental Hygiene License, ACHA/DN/004-(Rev. 5/96), effective 8-49-97;

(3) Financial Interest Disclosure Form, DH-MQA 1208 (Revised 8/97), DPR/DN/017-(Rev. 5/97/), effective 8/49/97;

(4) Application for General Anesthesia Permit, DH-MQA 1205 (Revised 5/09) AHCA/DN/005-(8/96), effective 8-19-97;

(5) Application for Parenteral Conscious Sedation Permit, DH-MQA 1204 (Revised 5/09) AHCA/DN/006-(8/96), effective 8-19-97;

(6) Application for Pediatric Conscious Sedation Permit, DH-MQA 1203 (Revised 5/09) AHCA/DN/008-(12/96), effective 8-19-97;

(7) Application for Certification for Dental Radiographer, DH-MQA 1202 (Revised 5/09) AHCA/DR/001-(Rev. 5/95), effective 8-19-97;

(8) Application for Continuing Education Credit for Individual Study, DH-MQA 1207 (Revised 5/09) Instructors, Teachers and Lecturers, AHCA/DN/009-(4/86), effective 8-19-97;

(9) Application for Biennial Providers of Continuing Education, AHCA/DN/001-(4/86), effective 8-19-97;

(9)(10) Application for Dentist/Dental Hygienist Limited Licensure, DH-MQA 1201 (App New, Effective 9/01) DOH/MQA/DNDH LL APP/new, effective 9-20-01.

(10)(11) No change.

Rulemaking Authority 466.004 FS. Law Implemented 120.52(15) FS. History–New 8-19-97, Amended 9-20-01, 5-28-09, ________.

NAME OF PERSON ORIGINATING PROPOSED RULE: Board of Dentistry
NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Board of Dentistry
DATE PROPOSED RULE APPROVED BY AGENCY HEAD: December 12, 2008
DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAW: December 12, 2008