Dental Hygiene Practitioners of Ontario (DHPO) Membership Application Form

Please review the following terms and conditions carefully before completing your application.

Terms of Registration

Upon submission, the DHPO will review your application for verification. The DHPO reserves the right to contact applicants for additional information prior to approval. Membership may be denied or revoked if provided information is inaccurate, outdated, or fails to meet established eligibility criteria.

• Membership Term: The membership year runs for a fixed 12-month term from June 1st to May 31st.

• Fees: Membership fees are not prorated; late submissions are subject to the full annual fee. All membership payments are non-refundable. Annual fee is subject to internal review and may change annually.

• Auto-Renewal: THIS IS NOT THE AUTO RENEWAL FORM

  Enrolment in auto-renewal must be completed prior to the commencement of the term (June 1st) and cannot be applied retroactively.

  
  

Eligibility Requirements

To be eligible for membership with the DHPO, applicants must:

1. Be an Active Registered Dental Hygienist in good standing with the College of Dental Hygienists of Ontario (CDHO).

2. Own and operate a dental hygiene practice within the Province of Ontario.

3. Members must provide proof of business ownership and professional licensure upon request at any time during their tenure.

4. Any changes to ownership status or CDHO standing must be reported to the DHPO immediately.

5. Failure to maintain eligibility or any instance of professional misconduct may result in the immediate revocation of membership.

Member Commitment

As a member of the DHPO, you join a professional collective dedicated to the advancement of dental hygiene practice. We encourage active participation in:

• Professional Advocacy: Strengthening our collective voice to influence industry standards.

• Research & Data: Contributing to business statistics and closing research gaps within the field.

• Engagement: Completing member surveys, participating in networking opportunities, and supporting peer growth.

  
  

Privacy & Consent Declarations

General Privacy Consent

By submitting this application, I hereby consent to the Dental Hygiene Practitioners of Ontario (DHPO) collecting, using, and disclosing my personal and professional information as described in their Privacy Policy. I understand that this information is collected for the purposes of:

• Verifying my membership eligibility and professional standing with the CDHO.

• Managing my membership account and providing access to member-only portals and communications.

• Conducting professional research and advocacy activities on behalf of the membership.

Business Address

For Mobile practices please use the same address as shown on your CDHO portal.

Please select the Business Type that best describe your business set up

Please note we may require a copy or proof of your business registration at anytime during your membership or to confirm eligibility of membership.

CASL Compliance (Email Communications)

In accordance with Canada’s Anti-Spam Legislation (CASL), we require your express consent to send you commercial electronic messages, including newsletters, event invitations, and promotional offers.

Third-Party Disclosure Consent

I further consent to the DHPO sharing my name and business contact information with authorized third-party partners (e.g., affinity programs, insurance providers, or professional research firms) for the purpose of providing me with exclusive member benefits or participating in industry-wide data collection.

Applicant Declaration

I certify that the information provided in this application is true and complete to the best of my knowledge. I understand that any false statements or omissions may result in the immediate denial or revocation of my membership. I acknowledge my right to withdraw this consent at any time by providing written notice to the DHPO, subject to reasonable notice and legal/contractual restrictions

Credit Card Information & Payment Authorization

The DHPO is committed to protecting your financial data. By providing your credit card information, you acknowledge and agree to the following:

• Purpose of Collection: Your credit card information is collected solely for the purpose of processing membership fees, including late fees or auto-renewal charges as selected.

• Security Measures: We use industry-standard encryption and secure payment gateways to ensure your cardholder data (PAN, CVV, Expiry) is transmitted and stored securely.

• Authorization: You authorize the DHPO to charge the provided credit card for the full membership fee. If you have enrolled in Auto-Renewal, you authorize an annual recurring charge on June 1st until such time as you provide written notice of cancellation.

• Refund Policy: As stated in the Terms of Registration, all membership submissions and processed payments are non-refundable.

Click Submit to proceed to payment