DenTemps Application
Email address *
Dental Hygienist
Last name: *
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First name: *
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Middle name:
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Position: *
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Home address: *
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Mailing address (if different)
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Phone number: *
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Alternate number:
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Email address: *
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Alternate email:
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How did you hear about DenTemps? (Select all that apply) *
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Did anyone refer you to working with us? If so, please let us know so we can thank them! *
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Are you interested in: *
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What days are you available to temp? *
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What cities will you work in? *
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When are you available to begin temping? *
Your answer
If in transition to a new position, when is your last day available for temp work?
Your answer
If looking for perm, how far are you willing to commute for a permanent position?
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Objective / Career Goal
Tell us what you hope to achieve!
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Work History *
List the dates of employment, position/ job title, and name of the company / office / DDS. You may also list duties and responsibilities as well
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Education *
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Hobbies / Extra Curricular Activities / Interests
Feel free to tell us about yourself!
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Honors and Awards
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Computer and Dental Software Experience *
Select any that you have experience with.
Required
What X-rays are you familiar with?
References *
Names and phone numbers of 2-3 professional references. We need someone who has supervised your work. Friends, family and other hygienists will not do
Your answer
Procedures Checklist
Will you work as a Dental Assistant if there is no Hygiene work available? *
If yes, please tell us about your experience.
Your answer
Will you work as a Hygiene Assistant if there is no Hygiene work available?
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Will you do sealants? *
Please tell us about your experience level
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Will you do scaling and root planing? *
Please tell us about your experience level
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Will you place arestin? *
Please tell us about your experience level
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Will you do FMX? *
Please tell us about your experience level
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Do you have any perio experience? *
How comfortable do you feel doing that? Was it in a specialty or general practice?
Your answer
Do you have any pedo experience? *
How comfortable do you feel doing that? Was it in a specialty or general practice?
Your answer
Do you have any endo experience? *
How comfortable do you feel doing that? Was it in a specialty or general practice?
Your answer
Are there any other skills/experience that would like for us to know?
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