Other Information

Select your first language (the language of your birth). If you speak additional languages, click Add Another Language. Then, select the language(s) and the level of your proficiency in each.

Indicate whether you have ever had any certification, registration, license, or clinical privileges revoked, suspended, or in any way restricted by an institution, state, or locality. If yes, enter an explanation in the spaces provided.

Indicate whether you have ever been disciplined or placed on academic probation while attending an academic institution. If you select Yes, enter a brief explanation in the field provided. Include 1) a brief description of the incident, 2) specific charge made, 3) related dates, 4) consequence, and 5) a reflection on the incident and how the incident has impacted your life.

Enter your DENTPIN. This is a unique identification number that is assigned by the American Dental Association. Visit the American Dental Association site for more information or to obtain a DENTPIN.

Indicate if you previously applied to any dental medical colleges or universities. If you select Yes, select the most recent year you applied from the drop-down. Use the entering year of the fall semester when you would have enrolled. Report only applications submitted before the current ADEA CAAPID application cycle.

Then, explain what has changed since your last application, list the school(s) you applied to, and explain any weaknesses you perceived in your previous application and what you did to address them.

Indicate whether you previously attended a health profession program as a candidate for a professional degree, in the United States or Canada, regardless of completion.

If you select Yes, indicate the number of programs attended, the types of programs, and details about your degree and attendance. 

Indicate if you have any relatives who are associated with the dental profession (this includes professional work, education, and related experiences). Then, enter their name(s) and additional details.