Dental Hygiene Examination Forms
The following material contains those forms used by CITA in the administration of its licensure examinations. These forms are being provided to assist candidates who might wish to become familiar with their content and usage. These forms are also provided to candidates, on an as needed basis, during the various stages of CITA’s application and examination process. These forms are for information purposes only and the forms downloaded from this site are NOT for candidates to bring and use during the examination, with the exception of the Treatment Selection Worksheet and Radiograph/Follow Up Care Forms.
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2015 Application Forms
2015 Miscellaneous Examination Forms
Testing Site Facility Information
2014 Dental Hygiene Examination Forms and Grade Sheets
Patient Consent Form
Medical History Form
Treatment Selection Worksheet
Pre-Treatment Evaluation Station Request Form
Post-Treatment Evaluation Station Request Form
Radiograph/Follow Up Care Form