Allied Health Tech Auxiliary

Requirements for Dental and/or Maxillofacial Prosthetic Technicians

  1. Be licensed, registered or otherwise permitted by law to practice as a dental or maxillofacial prosthetic technician.
  2. Be involved in patient care solely as directed or prescribed by licensed and qualified dentists.
  3. Must be recommended for membership by one Fellow and a second Fellow or Associate Fellow.
  4. Submit three patient case reports that demonstrate experience in providing some aspect of maxillofacial prosthetic technical procedures.
  5. The applicant will present a paper or table clinic at an annual session meeting involving some aspect of maxillofacial prosthetic technical procedures.

The dental and maxillofacial prosthetic technician auxiliary will pay dues but is ineligible to vote or hold office.

Personal Information














Academic Training

 InstitutionDegreeYear
Pre-Dental or Pre-Medical
Dental or Medical
Graduate

Post Graduate


Specialty Board Certification

Certified?
     



Fellow Program



Residential Program



Student Program







Teaching or Hospital Appointments


Research Experience




Names of two Active Fellows of the Academy from whom the Secretary may obtain an endorsement




Privacy Information

Show in member directories?
     

Who can view member details?
         

Do you consent to receive email communications from us, regarding your membership?
     

Yes, I agree to abide by the Constitution, By-Laws and other rulings of the Academy as well as such changes and amendments as may thereafter be properly adopted.