Dental Staffing Agency

Job Seekers

If you are a certified dental professional seeking additional hours or have recently completed a dental certification program and are looking for a seamless and secure entry into the dental industry, we are here to help.

Pacific Dental Temps has developed strong connections and a reputable name within the dental community which allows us to effectively secure a temporary or permament job placement tailored to your needs. Our placements are complimentary, all you need to do to get started is fill out a Pacific Dental Temps application form.

Please submit your application below. We will contact you within 24 hours after the form has been submitted.

PDT Application Form

Personal information:

Full name (required)



Postal code


Home telephone

Cell number (required)


Birthdate (dd/mm/yy)

Experience and skills:

1. Position(s) applying for:
 CDA Registered dental hygienist Reception Chairside assistant

2. Type of practice you've worked in:
 General Orthodontist Endodontist Periodontist Prosthodontist Pedodontist Oral surgeon

3. Are you seeking full or part-time work?
 Full-time Part-time Casual

4. Rate of pay expected (hourly and/or salary):

5. Availability:

 Monday Tuesday Wednesday Thursday Friday Saturday Sunday

6. How many months/years experience do you have in the position(s) applying for?

7. What dental software program(s) are you familiar with?

8. Relevant courses and/or education completed:

9. At which institution(s) were your programs or courses completed?

10. License number:

11. Do you have any conditions which could limit your ability to perform the job applying for?

 Yes No

12. Do you have any conditions which could be aggravated by the job applying for?

 Yes No

13. Are you bondable?

 Yes No

Record of employment:

Name of current/last employer

Length of employment


Reason for leaving

Name of previous employer

Length of employment


Reason for leaving

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