Certification for employment as a dentist for at least two years full-time, including at least one year



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Certification for employment as a dentist for at least two years full-time, including at least one year

(1440 hours) of pediatric dentistry









As a supervision dentist I endorse with my signature and stamp the duration of the following employment.

I am aware that this certification is the basis for the Danish Health Authorities´ decision on recruitment for the postgraduate training in orthodontics. See. § 4 pcs. 3 of the Danish Decree on the training of specialized dentistry (BEK 1020 of 26/08/2010).









NAME OF APPLICANT DENTIST: _____________________________________________

National authorisations ID and country: _____________________________________







Have been employed in:

_Pediatric dentistry

During the period from:__________

to:___________________________

Total_____months with a total hours of:


_ Adult dentistry





During the period from:__________

To:____________________________







Total_____Months with a total hours of:










Supervising dentist:




Name: __________________________________________________________________

Clinic adress: ___________________________________________________________

Phone:__________________________________________________________________




National authorisations ID and Country: ________________________________________________________________________
















Date and signature from supervising dentist_____________________________________

Stamp


Please send this certificate to:

Section of Orthodontics
Dpt. of Dentistry, Aarhus University
Att.: Section secretary Trine Zederkof Jønsson
Vennelyst Boulevard 9, DK-8000 Aarhus C

If this certificate are signed by a dentist outside Denmark, a copy of his/her certificate of authorisation to practice issued by the health authorities, has to be attached.


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