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Self-Reporting Form

The duty to report is a legal obligation that serves the public interest. Various authorities require health care professionals to report information (e.g., the College, Health Canada, Government of Alberta).

The College's Duty to Report Standard of Practice states that: "The dental hygienist is responsible for being aware of, understanding, and following all mandatory reporting requirements." You must be aware of your own circumstances that may affect your ability to practice safely and competently.

The College has also developed Duty to Report Guidelines to support dental hygienists in understanding and meeting their legislated requirements, standards of practice, and code of ethics.

Use this form to self-report the following to the College:

  • Any injury, dependency, infection, or any other physical, cognitive, mental and/or
    emotional condition that has immediately affected, or may affect over time, your
    continuing ability to practice safely and competently;
  • Any findings of professional negligence or malpractice;
  • Any findings of unprofessional conduct by a regulatory authority in another
    jurisdiction or by any other college under the Health Professions Act;
  • Any charges or convictions of a criminal offense;
  • Sexual abuse of or sexual misconduct with a patient as defined in the Health
    Professions Act

 Once the College has reviewed the form, you will be contacted by College staff.