Regulation 4
SCHEDULE 3E+WInformation and Documents to be Supplied on an Application for Registration as the Manager of a Private Dental Practice
PART 1E+W
InformationE+W
1. The applicant’s full name, date of birth, current address, telephone number and electronic mail address (if any).
Commencement Information
I1Sch. 3 para. 1 in force at 1.4.2017, see reg. 1
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.
Commencement Information
I2Sch. 3 para. 2 in force at 1.4.2017, see reg. 1
3. Details of the applicant’s professional training relevant to carrying on or managing a private dental practice.
Commencement Information
I3Sch. 3 para. 3 in force at 1.4.2017, see reg. 1
4. Details of the applicant’s employment history, including the name and address of their present employer and of any previous employers.
Commencement Information
I4Sch. 3 para. 4 in force at 1.4.2017, see reg. 1
5. Details of any business the applicant carries on or manages or has carried on or managed.
Commencement Information
I5Sch. 3 para. 5 in force at 1.4.2017, see reg. 1
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.
Commencement Information
I6Sch. 3 para. 6 in force at 1.4.2017, see reg. 1
7. The name, address, telephone number, facsimile number (if any), and electronic mail address (if any) of the private dental practice.
Commencement Information
I7Sch. 3 para. 7 in force at 1.4.2017, see reg. 1
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.
Commencement Information
I8Sch. 3 para. 8 in force at 1.4.2017, see reg. 1
PART 2E+W
DocumentsE+W
9. The applicant’s birth certificate.
Commencement Information
I9Sch. 3 para. 9 in force at 1.4.2017, see reg. 1
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.
Commencement Information
I10Sch. 3 para. 10 in force at 1.4.2017, see reg. 1
11. A statement by the applicant as to the state of their physical and mental health.
Commencement Information
I11Sch. 3 para. 11 in force at 1.4.2017, see reg. 1
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.
Commencement Information
I12Sch. 3 para. 12 in force at 1.4.2017, see reg. 1