Periodontal Program Admission and Information Update Form

Use this form to update your school's perio program admission and information on perio.org.

Members Only Content:

Not Member Only

REQUIRED INFORMATION

Name of University or Institution: *

Your Name: *

Your Position: *

Your Email: *

OPTIONAL UPDATES

If your postdoctoral program already has a profile in the AAP guide, please do NOT reenter all of the information requested below. Enter ONLY what needs to be changed on your program profile, and leave other fields blank.

Name and Mailing Address of Your Postdoc Program:

School Address 2:

School Address 3:

Program Director:

(indicate full-time or part-time, if desired)

Program Phone:

Program Fax:

Program Email:

Program Website Address:

Application Deadline:

Application Fee:

Start Date:

Accreditation Status:

Number of Faculty Members:

(May indicate number of full-time, number of part-time, and number board-certified, if desired)

Do you accept students not trained in a U.S. or Canadian dental school?

Yes

Length of Program in Months:

State License Required?

Yes

Degrees / Certificates Offered:

Prerequisites:

Tuition Per Year:

Cost of Instruments & Equipment:

Salary or Stipend:

First-Year Enrollment:

Ratio of Acceptances to Applicants:

Duration (in Hours) of Specific Training:

(Such as pathology, anesthesia, implants, nitrous oxide, IV sedation, microsurgery, etc.)

Hours Spent in Clinical Patient Treatment:

Type of Implant System(s) Taught:

Number of Implant Cases Completed per Residency:

Percent of Time Spent in Courses / Lectures / Seminars:

Percent of Time Spent in Research:

Percent of Time Spent in Teaching:

Percent of Time Spent in Clinical Treatment:

Clinical Setting:

Associated Hospitals:

On-Call Arrangements:

Average Number of Surgical Procedures Per Residency (excluding implants):

Average Number of Cases Completed Per Residency:

Research Requirements:

Residencies in Other Dental Specialties:

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Periodontal Program Admission and Information Update Form