Continuing Education
Agreement

REFUND POLICY
CHANGE OF COURSE START DATE/CANCELLATION
Fullerton Dental Assistant School reserves the right to reschedule the program start date when the number of the students scheduled is too small. If the student does not wish to start on the new start date, a full refund of all tuition and fees will be returned.
• Once registered for a course, students may not change their course start date.
• CPR, OSHA, Infection Control, Dental Practice Act, Radiation Safety, Coronal Polish, Pit and Fissure Sealants and Specialized Individual Training courses are non-refundable once registration is processed.
• Cancellation/ withdrawal request must be submitted in writing on a school form.

WITHDRAWAL
If the student chooses to withdraw after starting the program or is withdrawn by Fullerton Dental Assistant School, the student will not receive a refund of any type. If a student does not attend and/or misses any day of the Continuing Education classes, the student must pay the fee to retake the Continuing Education class to be able to continue and to receive their certificate. Students must meet all Continuing Education Courses requirements. Student will have ten days from the withdrawal date to pay their balance in full.
Fullerton Dental School reserves the right to discontinue or terminate any students’ training for failure to maintain satisfactory academic progress; failure to abide by the rules and regulations of the institution; absences or tardiness in excess of maximum set forth by the institution; and/or failure to meet financial obligations to the School.

I have read and agreed to the additional fees agreement

I have read and agreed to the following understandings

I understand that in taking Continuing Education courses with Fullerton Dental Assistant School I must abide by all course prerequisites, patient requirements and criteria as listed below. I will submit all prerequisites and certifications prior to class. I am aware that not meeting the course prerequisites or patient requirements and criteria will result in a failing grade therefore requiring me to pay the full course fee again if I choose to retake the course. I understand Fullerton Dental Assistant courses are not refundable.

Please read and approve

Must be able to communicate and understand English (reading and writing)
● Must be at least 18 years old (Students who are below 18 years old can take the dental assisting program without CE courses)
● Must have valid State Identification or U.S. Passport
● Social Security Number or Individual Taxpayer Identification Number (ITIN)

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IMMUNIZATION RECORDS

• Proof of Hepatitis B Vaccine (three course vaccine)
• Tuberculosis Test; (result must be negative and no more than 1 year old, positive results require a chest x-ray with Dr’s report, results must be negative and no older than 5 years)

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CPR Card-BLS Healthcare Provider (required for Infection Control and Dental Practice Act, Radiation Health & Safety, Coronal Polish and Pit & Fissure Sealants)
● Infection Control Certificate 8hr Class (required for Radiation Health and Safety, Coronal Polish and Pit & Fissure Sealants)
● Coronal Polish Certificate (required for Pit & Fissure Sealants)

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The Radiation Health & Safety course requires students to attend lecture, complete a written exam with a minimum passing score of  75% and complete all required mankin x-rays and take four passing full mouth surveys (FMX) on four different patients using bisecting technique on two patients and paralleling on two patients. 

*Each student is responsible for providing four patients for the clinical exam portion of the course ( we recommend you have additional patients lined up as back up).  All four patient clinical exams must be completed with a passing grade on the appointment date and time set up by the instructor. Clinical exam appointments will only be scheduled once lecture, exam and manikin x- rays have been completed. 

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• Patients must be 18 years or older
• Patients must be in good health (A medical history form will be completed prior to treatment and approved by the instructor).
• Patients must NOT be in the process of orthodontic treatment
• FEMALE ONLY- pregnant patients or patients who believe they might be pregnant are not candidates.   
• Patients cannot have dentures
• Patients cannot be missing more than one tooth per quadrant (implants and bridges will count as missing teeth), extracted wisdom teeth do not count as missing
• Patient’s last FMX (18-20 films) must have been taken at least one year from the date of clinical exam appointment, anything less than 18 x-rays or a pano taken in the last year is acceptable

Coronal Polishing Course requires students to attend the lecture, complete a written exam with a minimum passing score of 75% and successfully complete all required Coronal Polishing on manikin before the clinical exam on patients. Each student is responsible for providing three (3) patients who meet the patient criteria for the clinical exam portion of the course (we recommend you have additional patients lined up as back up).

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● Patients must be 18 years or older
● Patients must be in good health (A medical history form will be completed prior to treatment and approved by the instructor).
● Patients must NOT be in the process of orthodontic treatment
● Patients must be calculus free
● No dental cleaning or deep cleaning in the last three months (light plaque is okay)
● Patient cannot be pregnant (patients who believe they might be pregnant are not candidates)

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Pit and Fissure Sealant Course requires students to attend the lecture, complete a written exam with a minimum passing score of 75% and successfully complete all required Pit and Fissure Sealants on manikin before the clinical exam on patients.

Each student is responsible for providing four (4) patients who meet the patient criteria for the clinical exam (we recommend you have additional patients lined up as back up).

Please read and approve

● Patients must be 18 years or older
● Patients must be in good health (A medical history form will be completed prior to treatment and approved by the instructor).
● Each patient must have 4 virgin teeth (caries free and unrestored),1 tooth per quadrant, must be premolars, molars (except 3rd’s)
● Patients must NOT be in the process of orthodontic treatment
● Patient cannot be pregnant (patients who believe they might be pregnant are not
candidates)

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Students are responsible for providing the required patients for all courses they will be taking with Fullerton Dental Assistant School .
● Students are responsible for pre-screening their patients to ensure they meet the patient criteria prior to appointment date.
● Once clinical exam appointments are assigned students will not be allowed to make any changes to their appointment date or time.
● Students must confirm patient appointment date and time to ensure patients arrive on time to their appointments.
● No one other than the scheduled patient will be permitted in the office and in the operatory at any time.
● Students must arrive on time to all classes, on clinical days students must arrive 15 minutes prior to the class start time. The door will be locked once class starts and any late students will not be permitted to attend class. Students will not be permitted to use Fullerton Dental Assistant instructors or classmates/students as patients.
● Any dishonesty or falsification of records will result in dismissal from the class/program and will be reported to the Dental Board of California.
● Students are expected to conduct themselves in a respectful and professional manner with classmates, patients and all school staff, any misconduct is grounds for dismissal from the class/program.
● Full payment for the course will be required if the student wishes to retake a course
● No exceptions will be made to school policies.

If a student makes arrangements with Fullerton Dental Assistant School to complete part of their clinical exam in their office they must have authorization from the dentist who
will be supervising them at their office. Student’s supervising dentist must agree to supervise the students while they take x-rays, coronal polish or place sealants on patients. The dentist supervising the student at their office must also agree to complete all necessary forms for each patient and each procedure.
● After arrangements have been made by the students and Fullerton Dental Assistant School to complete part of their clinical exam at their office, students will not be permitted to make any changes to that arrangement and will be responsible to complete their patients in their office as agreed at registration.
● Students must complete their clinical exam within 2 weeks of the class starting date, and all documents must be submitted on time and completed correctly by the patient, student and supervising dentist. We will only accept original copies of the documents.
● For X-Ray class: When submitting documents, you must submit the original patient health history form, contract of affiliation, FMX Prescription and FMX mount with 18 images printed with office name, patient first and last name, patient date of birth and >original date on the document (hand-written information will not be accepted.)
● Students must attend class for lecture, exam, manikin and the required number of patients for clinical exam before they can work on any patients in their office as part of their clinical exam.
 

I have read and agree to the Drug Free/Zero Tolerance School Policy