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    Anesthesia and Sedation Forms

    Note: If you are applying under a conscious sedation or general anesthesia certificate, you must also apply under the pediatric sedation endorsement if you will be administering sedation to pediatric patients ages 8 years or younger.

    Pediatric Sedation Endorsement Application Form

    Allied Sedation Monitoring Certification Application Form

    Conscious Sedation Application Form

    Conscious Sedation Re-certification Form

    General Anesthesia Application Form

    General Anesthesia Re-certification Form

    Sedation Contractor INITIAL-RENEWAL Form

    Adverse Reaction Form

    Inspection Checklists

    CS Inspection Checklist and Self-evaluation Form

    CSS Inspection Checklist and Self-evaluation Form

    GA Inspection Checklist and Self-evaluation Form

    Connect with us

    Minnesota Board of Dentistry

    335 Randolph Ave, Suite 250

    Saint Paul, MN 55012
    dental.board@state.mn.us

    Phone: 612-617-2250*

    Fax: 651-797-1373

    Toll Free: 888-240-4762

    Hearing/Speech Relay: 800-627-3529

    *Language Line Translation Service Available
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