Except as otherwise required by Subsection C of 16.5.21.8 NMAC, presumptive public service dental hygienist do not need to comply with the following for presumptive public service licensure. All other applicants for temporary or public service licensure must submit the required fees and following documentation:

1. A. completed application, signed and notarized with a passport quality photo taken within six months affixed to the application; applications are valid for one year from the date of receipt;
2. B. proof of current basic life support (BLS) or cardiac pulmonary resuscitation (CPR) certification accepted by the American heart association, the American red cross, or the American safety and health institute (ASHI); cannot be a self-study course;
3. C. copies of all valid licenses and a letter from the applicant attesting to the status of each license;
4. D. an affidavit from the New Mexico licensed dental hygienist or dentist who will sponsor the applicant, attesting to the qualifications of the applicant and the activities the applicant will perform;
5. E. a list of activities to be practiced and the time period for which the temporary or public service license is requested;

6. F. in addition, applicants requesting temporary or public service licensure in public health must submit the following documentation:

   (1) official transcripts or an original letter on letterhead with a raised embossed seal verifying successfully passing all required courses from the dental hygiene program, to be sent directly to the board office from the accredited program;

   (2) copy of national board examination certificate or score card; and

   (3) proof of having taken a course in infection control technique within the past 12 months.

   [3-14-73, 5-31-95, 9-30-96; 16.5.21.10 NMAC - Rn, 16 NMAC 5.21.10, 12-30-02; A, 04-16-08; A, 09-18-10; A, 01-09-12]