Letter of Good Standing Request: CRDHA

Current or former registrants of the College of Registered Dental Hygienists of Alberta (CRDHA) can request a Letter of Good Standing to be sent to another regulatory body or other institution by completing the online form below.

If the regulatory body or other institute requires you to submit a specific form, please have it available for uploading within the online form.

The normal processing time for this request is 15 business days. All requests are dealt with in the order of receipt. The fee is $25 per Letter of Good Standing. We will contact you by telephone when we receive your completed online form to arrange payment by Visa or MasterCard. Processing of your request begins as soon as we receive payment.

FORM to Request Letter of Good Standing from the CRDHA

Please complete this online form to request a Letter of Good Standing from the CRDHA. Prior to submitting a request, please ensure that you have reviewed the instructions and requirements of the institution requiring this letter.

Some institutions require the CRDHA to submit the information directly to them. In this case you will need to provide complete and accurate contact information.

Some institutions require completion of proprietary forms. There is a place for you to upload one within the CRDHA request form.

By submitting this request form, you are consenting to the disclosure of information related to your registration with the CRDHA to any third party you identify in your request.

This information is provided pursuant to the Health Professions Act (the Act) and includes:

Names we have on file for you
The date you were first registered with CRDHA and any expiry date(s)
Whether your practice permit was suspended or cancelled
If there were conditions on your practice permit
If directions had been made to cease providing professional services under the Act
If a professional conduct hearing has been held or scheduled respecting your conduct
If there are ongoing or current proceedings with respect to any professional conduct complaints against you

Surname *

Given Names *

Include middle name(s) if any

Maiden Name or Other Names (if applicable) *

Write not-applicable if appropriate

Your Registration Number (Practice Permit) with CRDHA *

Home Address *

City *

Province or State *

Postal Code (if in Canada)

Country and Postal Code if not in Canada

Applicant Email *

Applicant Cell phone *

Applicant Alternate Phone

Telephone Country Code (or other notes regarding telephone numbers)

Where is the completed Letter of Good Standing to be sent? *

Applicant

Institution

If the request is to be sent to an institution, please provide the complete mail or email instructions, including the institution name, in the box below. Please check your submission for accuracy.

If CRDHA is submitting the Letter of Good Standing to an institution, do they require us to use their form?

Yes

If you answered Yes above, please upload the form here

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