World Dental Council International Accreditation

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Registration Form

Are you a new or existing member? *

I am a New Member

I am an existing member

If existing member, enter your Certificate Membership Number and Expiry Date

Member info

Proprietor/ Director's Name *

Educational Qualification *

E-mail *

Job Title *

Clinic/ Hospital Name *

Website *

Category *

Total Revenue Per Annum *

Date of Registration/ Opening *

No. of Branches *

Is your Clinic/ Hospital has ISO registration? *

Do you have any other International Accreditation? *

If yes, Enter details:

Total No. of Qualified Healthcare/ Dental Professionals *

Details of Full Time Employees (Name, Education, Date of Joining, Designation) *

Details of Infection Control Protocol and Waste Disposal Methods *

Head Office Address: *

Phone number *

Country *

City *

Postcode *

Accreditation Level (Office Use Only)

1. Silver Provider 2999
2. Gold Provider 3999
3. Platinum Provider 4999
4. Diamond Provider 5999

General T & C's

1. Only Dental Professionals are eligible to register
2. Council reserves all the rights to remove and cancel the registrants providing false information
3. Registered Trademarks and Accreditation Logo of the Council should be used only by the registered and existing council members ONLY
4. Members are required to provide documentation when requested
5. Council will not be responsible for any misrepresentation and misunderstanding of the terms and conditions
6. By submitting you consent the council to keep and process your personal details

Agreement *

By Submitting, I agree to pay the Annual Accreditation fee and the terms & conditions of the World Dental Council

Required

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