- Latest available (Revised) - English
- Latest available (Revised) - Welsh
- Original (As made) - English
- Original (As made) - Welsh
This is the original version (as it was originally made).
Regulation 4
1. The applicant’s full name, date of birth, current address, telephone number and electronic mail address (if any).
2. Details of the applicant’s professional or technical qualifications, and experience of managing a private dental practice, so far as such qualifications and experience are relevant to providing services for persons for whom services are to be provided at the private dental practice.
3. Details of the applicant’s professional training relevant to carrying on or managing a private dental practice.
4. Details of the applicant’s employment history, including the name and address of their present employer and of any previous employers.
5. Details of any business the applicant carries on or manages or has carried on or managed.
6.—(1) The name and addresses of two referees—
(a)who are not relatives of the applicant;
(b)each of whom is able to provide a reference as to the applicant’s competence to manage private dental practice of the same description as the private dental practice; and
(c)one of whom has employed the applicant for a period of at least 3 months.
(2) The requirement for the name and address of a referee who has employed the applicant for a period of at least 3 months must not apply where it is impracticable to obtain a reference from a person who fulfils that requirement.
7. The name, address, telephone number, facsimile number (if any), and electronic mail address (if any) of the private dental practice.
8. If the applicant is a dentist or dental care professional—
(a)the responsible person’s professional registration number; and
(b)details of any conditions imposed on the responsible person’s professional registration or inclusion on a dental performers list.
9. The applicant’s birth certificate.
10. Certificates or other suitable evidence relating to the applicant’s professional or technical qualifications, so far as such qualifications are relevant to providing services for persons for whom services are to be provided at the private dental practice.
11. A statement by the applicant as to the state of their physical and mental health.
12. An enhanced criminal record certificate issued under section 113B of the Police Act 1997 and, as applicable, suitability information relating to vulnerable adults (as defined in section 113BB of that Act) or suitability information relating to children (as defined in section 113BA of that Act) or both, in respect of which less than three years has lapsed.
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Original (As Enacted or Made) - English: The original English language version of the legislation as it stood when it was enacted or made. No changes have been applied to the text.
Original (As Enacted or Made) - Welsh:The original Welsh language version of the legislation as it stood when it was enacted or made. No changes have been applied to the text.
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