Request Form

Course Request Form

To ensure your request is processed quickly and accurately, please complete the appropriate form below for cancellations, transfers, or duplicate certificate requests.

All cancellations, transfers, and certificate replacement requests must be submitted in writing using the official forms provided below. Requests submitted by phone or email will not be processed.

Please review the applicable policy pages before submitting your form.

Enrollment is confirmed only after payment has been received. Seats cannot be held without payment.

UF Continuing Education Course Policies

"*" indicates required fields

URL

This field is for validation purposes and should be left unchanged.

Profession*

Your Name*

First Last

Email*

Phone Number*

Request Type*

Please choose the type of request you would like to submit.

Enroll in a Course

Date of Birth*

Address*

Street Address Address Line 2 City State ZIP Code

Course Name*

Course Date*

Transfer Between Courses

Reason for Transfer*

Course Transferring From*

Date*

Course Transferring Into*

Date*

Transfer Policy*

Students may transfer to a different available date for a course up to two times, provided the request is made at least 7 days prior. Any further transfer requests will be treated as cancellations, subject to our cancellation policy. Failure to attend after the second transfer will also result in cancellation. We encourage early communication to accommodate requests within the transfer limit.

I understand that submitting this request does not guarantee my transfer will be approved, and I will be notified of any updates.

Course Cancellation

Course Name*

Date*

Reason for Cancellation*

Refund Policy*

Full refunds will be issued to registrants who cancel no later than 14 days before the course starting date. A 75% refund will be issued for registrants who cancel 7-13 days before the course starting date. A 50% refund will be issued for registrants who cancel 2-6 days before the course starting date. No refunds will be issued for registrants who cancel within 48 hours of the starting date. Refunds will be made to the original payment method within 8-10 business days.

I have read the refund policy

Bring a Team Member

Team Members may join their dentist in select courses for a reduced fee.

Team Member Name*

First Last

Email*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Course*

Date*

Dentist and Team Member Learning Opportunity Policy*

Eligible team members include: Dental Assistants, Dental Hygienists, Office Managers, Lab Technicians. This rate is not available to licensed dentists, specialists, residents, or dental students. Dental Team attendees do not perform clinical exercises independently or receive individual hands-on instruction. Dental Team attendees do not receive CE credit for any part of the course.

I have read and agree to the policy

Certificate Reprint Request

Requested Record Type*

Printed Documents are awarded at the end of each course. Full page printed Certificates are commonly used in Dental Assistant and Dental Hygienist Certification Courses.

No Fee – Digital CE Certificate – PDF

$30.00 – Physical Mailed Certification Document

Course Name*

Course Date*

Acknowledgement

Please note that due to record retention policies, the Continuing Dental Education cannot guarantee the availability of records after seven (7) years. Regarding Physical Documents – Once we have verified your certificate, we will contact you for payment.

I agree