OUTPATIENT PEDIATRIC DENTISTRY

How to become accredited and maintain accreditation in our Outpatient Pediatric Dentistry Program

Accredited pediatric dentistry facilities must meet standards written for the delivery of safe pediatric dental care requiring unique anesthesia delivery and disinfection practices. This program is designed to ensure optimal patient safety while meeting the specific needs of the pediatric dentistry community.

Accreditation Process for Outpatient Pediatric Dentistry

New Applicants

Below is a list of documentation that must be completed for the Outpatient Pediatric Dentistry Application. Please mail completed documentation to AAAASF at 7500 Grand Ave, Suite 200, Gurnee, IL 60031 or fax to 847-775-1985. You may also scan and email to [email protected].

  • Application Form with payment
  • Floor plan for facility
  • A copy of each physician/dentist State Medical License
  • A copy of each physician/dentist Board Certificate or letter of admissibility by the certifying board
  • Authorization to Release Information Form signed by each physician/dentist on staff
  • HIPAA Business Associate Agreement
  • Facility Identification Form
  • Staff Identification Form
  • Facility Director’s Attestation Form
  • Random Review Form

Once the documentation is received in the AAAASF office it will be reviewed within 10 business days and you will be contacted if additional paperwork is needed.

Please review the Standards and Checklist Manual carefully before submitting the completed documentation to AAAASF.

Download Documents

 

Parents & Guardians

Are you looking to better understand what it means if your child’s pediatric dentist is accredited by AAAASF? Learn more about why you should choose an accredited facility.