Member Cancellation Information
A standardized process for members who are leaving or retiring from the practice of dentistry in the Province has become necessary to manage increasing membership numbers. In addition, there are some regulatory responsibilities regarding notification and patient records that dentists need to be aware of and manage prior to leaving practice in the Province.
The term resignation is used to encompass all situations where a member is leaving the practice of dentistry in the Province.
In order to meet these needs, please complete the form and declarations on the reverse of this document. Until this signed form is received at the MDA offices, you are considered a member with the same responsibilities and obligations to meet continuing competency requirements, maintain malpractice insurance and pay fees.
The MDA cannot remove you from the registry of practicing members and complete the CDSPI Request for Non-Practicing Status of Malpractice Insurance until this form is received.
If you submit this form before February 28th, you will not be required to pay the annual license renewal fee for the upcoming year. If you submit the form after February 28th, you will be required to pay the annual license fee. A failure to pay that fee may result in a default of payment being recorded in your file. A default of payment will affect your ability to be reinstated in the Province as well as registration in other jurisdictions.
You may apply to have your membership reinstated at any time. Reinstatement will be governed by the legislation, bylaws and policies in place at the time of application for reinstatement.
Cancellation Package
