Third Party Request for Confirmation of Member Protection

If you are a third party requesting confirmation of a dentist's malpractice protection, fill out the form below. 

Member Information

Provide the name and RCDSO member I.D. number of the dentist who's malpractice protection you are confirming. The dentist's name should match their RCDSO registration details. 

Supported Files: .doc, .docx, .pdf, .jpg, .png, .txt

Request Details

Select Confirmation of Protection and indicate how your prefer to receive the letter. 


Confirmation of Protection
Send Confirmation Letter to:
Additional Information Optional

 Provide any additional details regarding your request for confirmation of protection.