Information and documents to be provided by an applicant
5.—(1) An application for registration must —
(a)be in writing on a form approved by the registration authority;
(b)be sent or delivered to the appropriate office of the registration authority;
(c)be accompanied by a recent photograph of the applicant, of whom the photograph shall be a true likeness;
(d)give the information or be accompanied by the documents that the applicant is required to provide in accordance with paragraph (2), (3) or (4); and
(e)be accompanied by a fee of £50 in respect of each applicant.
(2) Subject to paragraphs (3) and (4) a person who is seeking to be registered as a person who provides dental services privately must provide to the registration authority full information listed in sub-paragraphs (a) to (k) and (m) —
(a)the applicant’s full name, date of birth, home address and telephone number and an address (which may be the home address) at which the dentist may be contacted by patients;
(b)chronological details of the applicant’s professional experience, both before and after graduation, so far as relevant to the provision of dental services including periods of self employment, dates of all posts held, the reason for leaving each post and explanation for any gap between posts;
(c)the name and addresses of two referees —
(i)who are not relatives of the applicant;
(ii)each of whom is able to provide a reference as to the applicant’s competence to provide dental services; and
(iii)each of whom is able to provide a reference which relates to a recent period of employment or post of at least 3 months;
but in respect of each referee where the registration authority is satisfied that it is not practicable to obtain a reference from a person who fulfils the requirement in sub-paragraph (iii), a full explanation and the name and address of an alternative referee who does not meet those requirements;
(d)a declaration that he or she is included in either the dentists register or list of visiting EEA practitioners;
(e)either his or her professional registration number and date of first registration or a visiting EEA Dentist Certificate;
(f)a certificate of insurance for the applicant in respect of liability which may be incurred by him or her in relation to the provision of dental services in respect of death, injury, public liability, damage or other loss;
(g)his or her professional qualifications and where they were obtained, with evidence concerning his or her qualifications and experience;
(h)the applicant’s birth certificate or, if the applicant was born outside the United Kingdom, his or her passport;
(i)where the applicant is not a national of an EEA state evidence of the applicant’s proficiency in the English language to a level necessary for the provision of dental services;
(j)an enhanced criminal records certificate —
(i)which has been issued under section 115 of the Police Act 1997(1); and
(ii)the application for which was countersigned by the registration authority;
(k)a statement by the applicant that they are complying with and will continue to comply with, these Regulations in relation to the provision of dental services;
(l)a statement by the applicant that they are currently on a dental performers list and the name and address of the Local Health Board or Primary Care Trust that has published that list;
(m)details of any condition imposed on his or her professional registration or inclusion on a dental performers list.
(3) A person who is seeking to be registered as a person who provides dental services privately and who is currently on an NHS dental performers list must provide to the registration authority full information listed in paragraphs (a), (k), (l) and (m).
(4) A person who falls within paragraph (3) but in respect of whom an enhanced criminal record certificate has not been obtained in connection with inclusion in that dental performers list must in addition provide the information listed in (j).