BY-LAWS - American Veterinary Dental College
Dental Chart Submission Form
This form is to be completed and signed by a Part-Time Resident
who works in facility separate from the Residency Supervisor.
(Submission and approval of Dental Charts is not required for
Full-time Residents working at the Supervisor’s facility)
Dental charts will not be reviewed if this completed Form,
including Supervisor ‘signature’, is not included in the DMS document.
Certification by Resident:
I certify that I have read the AVDC Dental Chart requirements provided online by AVDC (and available via the link above), and that these dental charts are used in my practice. (Note: There is no requirement that the resident designs the dental charts).
|Name of Resident | |
|Type of Dental Chart |Canine and Feline Equine |
|(delete as appropriate) |(delete one) |
|DMS Email address of Resident, in lieu of signature | |
Certification by Supervisor:
I certify that I have read the AVDC Dental Chart requirements provided online by AVDC (and available via the links above), that I have reviewed the Dental Chart(s) submitted by the resident, and that I approve the Dental Chart(s) as meeting the AVDC Dental Chart Requirements.
|Name of Supervisor | |
|DMS Email address of Supervisor, in lieu of signature | |
This form is to be completed and submitted as a file uploaded in the DMS Dental Chart document submission
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