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New Account Sign up

Please fill in your information and we will contact you. Choose which profile first - either Indepentant Contractor or Dental Office or Associate. All information is kept private and confidential and only released upon approval.

Get started with your Facebook account! (Optional - don't have one? Simply fill out the form!)

Using Facebook Profile Data for Sign up

You can start setting up your Dental Staff 911 account by pre-filling fields using your Facebook e-mail address and profile information. Log in to your Facebook account and never have to remember another password! (You are re-directed to Facebook, we do not get access to your password, and never will!)

My Login Information

Associate & Locum Profile

My Contact Information

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My Picture


(JPG, GIF, or PNG)

Problems uploading your profile picture?

Can't upload your profile picture file?

Occasionally, a file cannot be uploaded - not a problem!

Simply e-mail your file to info@dentalstaff911.com and we will happily add it to your profile for you.

My CV and Licenses


(PDF, DOC, DOCX, ODT or RTF)

Problems uploading your CV or licenses?

Can't upload your resume or license file?

Occasionally, a file cannot be uploaded - not a problem!

Simply e-mail your file to info@dentalstaff911.com and we will happily add it to your profile for you.

My Job Information


(Temp only applies to Locum.)
(Please first select what you are looking for.)


My Notes

How did you find out about us?

Please let us know how you found Dental Staff 911!

Name or city of trade show / symposium:    

Please tell us who (so we can thank them):    

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