National Dental Assisting Examining Board NDAEB Dental Assisting Course Work Report – Revised October 2024 - 13 - Non-Registered Program Graduate – Candidate Declaration: I declare that the information I have provided is factual with respect to the education and training I have completed. I understand that to be eligible for the NDAEB certificate, I must be trained to perform the mandatory core skills (intra- oral duties) as the operator and that I will be required to have my clinical skills evaluated by the NDAEB confirming my clinical competence. I understand that if I have not received the required education and training to meet the NDAEB standard, the NDAEB will direct me to attend an educational upgrade program at a Canadian educational institute before being granted exam eligibility. I acknowledge the mandatory intra-oral skills evaluated on the Clinical Practice Evaluation are: Skill 1 – Exposes Digital Radiographic Images Skill 2 – Obtains Impressions for Study Casts Skill 3 – Applies and Removes Dental Dam Skill 4 – Selective Coronal Polishing Skill 5 – Applies Treatment Liners Skill 6 – Applies and Removes Matrix Band and Wedge Skill 7 – Applies Anti-Cariogenic Topical Fluoride Gel Skill 8 – Applies Pit and Fissure Sealants Skill 9 – Applies Topical Anesthetic I further acknowledge that if I am applying from outside Canada, the NDAEB written examination and CPE are available only in Canada and that the granting of exam eligibility by the NDAEB in no way assures or implies acceptance for immigration or entry to Canada, nor does it guarantee the likelihood or possibility of attaining employment, registration or licensure as a dental assistant in a Canadian province. (See notes below). Candidate Signature Date **NDAEB will NOT accept the Candidate Declaration Form signed electronically. If signature and /or date is not included on the Candidate Declaration Form, a new signed and dated form will need to be mailed to head office before the application can be reviewed.
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