Temp Registration Form / Applicants | DenTemps Dental Staffing

Dental Temp Registration

Please complete our online application and upload the following:

(Resume)

If your a DA you will need to also upload a copy of your

Dental Assisting Diploma and x-ray license.

You will receive a follow-up email within 24 hours letting you know that your registered and let you know if we have anymore questions.

Thanks for joining our team!

Today's Date *

How did you hear about us *

First and Last Name *

Addresss, City, Zip *

Phone Number *

Email address *

Birthdate *

Years of Experience *

Dental License #

Do you Speak *

English
Spanish
Both

Are you Currently Employed *

Yes
No

Interested in *

Temporary
Permanent
Both

Available Start Date *

City's willing to travel to *

Software Profeciency *

Dentrix
Eaglesoft
Open Dental
Other

Is Your CPR Card Up to date *

Yes
Needs to be renewed
Going to expire soon

Are you vaccinated (covid-19 shots) *

Yes
No

Upload Resume *

Dental Assisting Diploma (DA's Only)

(DA's Only) X-ray License