Dental Assistant Program - Application Checklist

In order to be eligible for admission to the Dental Assistant program, students must complete the following eligibility requirements by the priority deadline. 18 students will be accepted each Fall. 

The Dental Assisting Program is accredited by the Commission on Dental Accreditation (CODA), a specialized accrediting body recognized by the Council on Postsecondary Accreditation and the United States Department of Education. This accreditation ensures that the Dental Assisting program is up to date on the latest curriculum and techniques in the dental industry. The Commission on Dental Accreditation can be contacted at (312) 440-4653 or at 211 East Chicago Avenue, Chicago 60611, or visit the webiste at

Fall Term (August) - Priority deadline is January 31

Eligibility Requirements

We adhere to CDC and OSHA guidelines. A copy of the Infection Control Policy is located in the Division Office.

Equal Educational Opportunity and Non-discrimination

It is the policy of Iowa Western Community College to provide equal educational opportunities and not to discriminate on the basis of race, color, creed, religion, national or ethnic origin, ancestry, genetic information, physical or mental disability, age, sex, sexual orientation, gender identity or expression, pregnancy, marital status, veteran status, AIDS/HIV status, citizenship, or medical condition, as those terms are defined under applicable laws, in its educational programs, activities, or employment practices.  Inquiries and complaints regarding equal opportunity and nondiscrimination policies should be directed to the Equal Opportunity Coordinators, phone number 712-325-3200,; or the Director of the Office for Civil Rights, U.S. Department of Education, Citigroup Center, 500 W. Madison, Suite 1475, Chicago, IL 60661, phone number 312-730-1560, fax 312-730-1576.

It is the responsibility of the student to ensure that all admissions requirements are documented in the Office of Admissions.



Dental Assistant Program - Observation Form for Prospective Students

To be completed by the student and signed by the participating Dentist or Dental Hygienist.

Student name (print or type): _________________________________________ Date of Birth: _________________________

The purpose of the observation is to expose applicants to a wide-variety of procedures performed in a dental practice setting. Applicants are required to observe a minimum of 8 hours with a Dental Assistant or Dentist. After completing the observation hours this form must signed by the supervising Dental Assistant or Dentist, and the completed form must be submitted to the Office of Admissions by the priority deadline.

Observation Log

Applicants are required to document the times and dates of their observation hours using the log below.

Date Time In Time Out Hours









    Total Observation Hours  

Registered Dental Assistant or Dentist Certification

This section must be completed by the supervising Dental Assistant or Dentist

By signing below, I hereby certify that the information provided on this form is true and accurate.

Signature(s) of Dental Assistant or Dentist: ________________________________, ____________________________

Printed Name(s) of Dental Assistant or Dentist: _____________________________, ____________________________

Name of Practice or Facility:

Address of Practice or Facility:

Phone Number of Practice or Facility:

Applicant Certification

By signing below, I hereby certify that all information on this form is true and correct.

Signature of Student: ______________________________________ Date: ____________________