Do you use: Removable Appliances Yes / No Functional Appliances Yes / No EOT Yes / No Straight-wire Appliances Yes / No Do you have any special interests: Self ligation appliances Yes / No Lingual technique Yes / No Orthognathic Surgery Yes / No Others Yes / No If yes, please indicate what formal training you have had in these areas: 13. What educational resources are available in the practice / department to support a student Orthodontic Therapist? 14. Do you have internet and e-mail access in the practice / Yes / No department? 15. Do you use digital photography in the practice / department? Yes / No 16. Are you prepared to engage in a formal weekly Yes / No discussion/seminar session with the student Orthodontic Therapist? 17. Are you willing to formally assess and monitor the student Yes / No Orthodontic Therapist’s development and provide regular reports on their progress? 18. Are you or any other members of your practice / department’s Yes / No training team already involved in training? If yes, please complete the Trainer/Supervisor Commitments Form and submit this along with this application.
Do you use: Removable Appliances Functional Appliances EOT Straight-wire Appliances Yes / No Yes / No Yes / No Yes / No Do you have any special interests: Self ligation appliances Lingual technique Orthognathic Surgery Others If yes, please indicate what formal training you have had in these areas: Yes / No Yes / No Yes / No Yes / No 13. What educational resources are available in the practice / department to support a student Orthodontic Therapist? 14. Do you have internet and e-mail access in the practice / department? Yes / No 15. Do you use digital photography in the practice / department? Yes / No 16. Are you prepared to engage in a formal weekly discussion/seminar session with the student Orthodontic Therapist? Yes / No 17. Are you willing to formally assess and monitor the student Orthodontic Therapist’s development and provide regular reports on their progress? Yes / No 18. Are you or any other members of your practice / department’s training team already involved in training? If yes, please complete the Trainer/Supervisor Commitments Form and submit this along with this application. Yes / No
d._ot_trainer_application_form_2016.docx