DenTemps Application
Email address *
Dental Hygienist
Last name: *
First name: *
Middle name:
Position: *
Home address (including city, state & zip): *
Mailing address (if different - including city, state & zip)
Phone number: *
Alternate number:
Email address: *
Alternate email:
How did you hear about DenTemps? (Select all that apply) *
Required
Did anyone refer you to working with us? If so, please let us know so we can thank them! *
Are you interested in: *
Required
What days are you available to temp? *
Required
What cities will you work in? *
Required
When are you available to begin temping? *
If in transition to a new position, when is your last day available for temp work?
If looking for perm, how far are you willing to commute for a permanent position?
Objective / Career Goal
Tell us what you hope to achieve!
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
Education *
Hobbies / Extra Curricular Activities / Interests
Feel free to tell us about yourself!
Honors and Awards
Computer and Dental Software Experience *
Select any that you have experience with.
Required
What X-rays are you familiar with?
Clear selection
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
Procedures Checklist
Will you work as a Dental Assistant if there is no Hygiene work available? *
If yes, please tell us about your experience.
Will you work as a Hygiene Assistant if there is no Hygiene work available?
Will you do sealants? *
Please tell us about your experience level
Will you do scaling and root planing? *
Please tell us about your experience level
Will you place arestin? *
Please tell us about your experience level
Will you do FMX? *
Please tell us about your experience level
Do you have any perio experience? *
How comfortable do you feel doing that? Was it in a specialty or general practice?
Do you have any pedo experience? *
How comfortable do you feel doing that? Was it in a specialty or general practice?
Do you have any endo experience? *
How comfortable do you feel doing that? Was it in a specialty or general practice?
Are there any other skills/experience that would like for us to know?
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