ADHP Membership Application

OCDS welcomes Allied Dental Health Professionals (ADHPs) to join our community! We value the vital role hygienists, assistants, and office staff play in dentistry and are proud to offer a membership designed just for you. As an ADHP member, you’ll enjoy access to select CE courses, networking opportunities, and resources that support your professional growth. Connect with local dental professionals, expand your knowledge, and be part of a community dedicated to advancing oral health together!

First Name*

Middle Name

Last Name*

Email Address*

Cell Phone*

Mailing Address* (Line 1)

Line 2 (Optional)

City*

State*

Zipcode*

Position*

License Number

Dental Hygiene / Dental Assisting School Name (If Applicable)

OCDS Member Dentist Employer*

OCDS Member Dentist License Number*

Office Address* (Line 1)

Line 2 (Optional)

City*

State*

Zipcode*