Candidate Job Request Registration Form

Please note, we require a copy of these documents before we can begin a job search on your behalf; they can be faxed to us at 519 741 0519 or by email to

  • Resume
  • Two references
  • License(s) – Hygienists, Dentists
  • Current Certificate(s) – Dental Assistants, Treatment Coordinators, Dental Receptionists


In the following form, all fields must be completed.

First Name (required)
Last Name (required)
Your Email (required)
Please re-enter your Email (required)
Your home phone:
Your alternate phone:
Apt or unit­­­­­­­­­­­­­­­­­­­­­­
Postal Code
I am looking for:
(check all that apply):
Full time permanentPart time permanentTemporaryContract
(check only one):
Dental Assistant (Level 1)Dental Assistant (Level II Certified / NDAEB)Hygienists, Restorative HygienistsTreatment CoordinatorsReception / Front DeskBusiness / Office ManagersDentist Locums
What dental software are you familiar with?
(check all that apply)
Abel DentDentrixTrackerDental WorksAutopiaLogi TechPractice Makes PerfectCleardentOther (specify in notes field)
What geographic area do you prefer?
(check all that apply)
Hamilton, Burlington, Oakville, Stoney Creek, AncasterGuelph, Waterloo, Elmira, Kitchener, CambridgeBrantford, SimcoeWoodstock, London
What starting compensation would you like?
(hourly or annual)
Hourly range: $ to $
Annual salary range: $ to $
Do you have a car to travel to/from work? YesNo
What additional languages do you speak and/or read?
Would you like us to edit your resume? YesNo
Are there any additional job details or comments you would like to include?
Specify days and hours you would like to work (minimum of 4.0 hours):
Example: Monday 9-5, Tuesday 5-8, Saturday 10-3
Day Hours Evenings
Monday YesNo
Tuesday YesNo
Wednesday YesNo
Thursday YesNo
Friday YesNo
Saturday YesNo
Sunday YesNo

Note: Should you need to make changes to your submission after sending it to us, please contact us with the new/updated information either by phone (519 496 2030) by fax (519 741 0519) or by email.