Duggan Dental Studies 2011
20311 SW Acacia Street
Suite 250
Newport Beach, CA 92660
Phone: (949)851-5126
Fax: (949)851-5128
Fundamentals of Clinical Dentistry
Licensure exam course
Agreement between Duggan Dental Studies and _____________________________________________________
We agree to provide a hands-on dentistry learning experience under the teaching of D. Michael Duggan, DDS, PhD.
This program consists of 140 hours of lecture and hands-on training. The 20 day program may be consecutive or may
be spaced over 3 to 4 weeks, depending upon the schedule. For more information on class times and schedules refer to
the website at www.dentistceprogram.com
This agreement is specifically for the course code: ____________________ starting on _____________________
This course is specifically designed to prepare you for the Western Regional Examining Board licensure examination.
The subjects covered during the course are as followed but not limited to: 1. Restoration of proximal lesions, anterior
and posterior, amalgam and composite materials; 2. Periodontal diagnosis and therapy; 3. Patient selection for
operative and periodontal procedures; 4. Prosthodontics lecture and hands on evaluations with Mock board for written;
5. Endodontics- hands-on, access, hand filing, and obturation; 6. Rubber dam applications and periodontal
measurements on student partners; 7. Mock Boards, simulated exam conditions with natural teeth; 8. Treatment
planning lecture and practice; 9. Access to clinical patient archives. After successful completion of the course each
student will be provided a letter of recommendation written by Dr. Duggan based on results from questionnaires and
evaluations given throughout the course.

Written knowledge questionnaire given prior to course registration

Pre course self-evaluation

Worksheet for each prep covered during the FRT online program (prior to start date)

Mirror skills workshop

Worksheets for each prep covered during the course

Graded mock board

Exit self-evaluation
The course will be held at The Duggan Dental Studies
20311 S.W. Acacia Street Suite 250, Newport Beach, CA 92660
The tuition for the 20 day course is $4,900. Please indicate payment plan of choice
o
Standard- $2,450 at registration, and $2,450 upon arrival
o
Thirds- $1,633 at registration, $1,633 every 3 months
o
Monthly- $2,450 at registration, and no less than $490 per month
Materials are not included in the course tuition, nor do we offer payment plans for purchasing materials. Students are
responsible for providing their own materials such as typodonts, handpieces, instruments, burs, ivorine and natural
extracted teeth, and other items used during the course. These materials are generally available for purchase at our
facility. However, if you need to purchase a typodont, a handpiece, or if you require left handed instruments, let us
know immediately. Students may rent handpieces from us during the course for a charge of $35, and Kilgore and
Columbia typodonts can be rented for a charge of $25 plus the replacement of teeth used or damaged. Endo typodont
are available for rent for a charge of $75 plus replacement of sextons. Both handpiece and typodont rental fees are
nonrefundable and nonnegotiable. Patient evaluations are available for $75 per ½ hour of Dr. Duggan’s time, including
detailed discussion of patient’s case. Protocol for patient evaluation will be discussed during the course.
The undersigned hereby authorizes the tuition charge indicated above. This acts as a deposit for the course and
insures an available position for the undersigned. All deposits are nonrefundable. Cancelations/switching courses are
allowed no less than 3 weeks prior to your original course date.
Signing below indicates acceptance of all terms of this agreement.
Mastercard or Visa ONLY
Card Number: ________________________________________ Expiration Date:___________________________ _V-Code__________
Billing Address: _________________________________________City/State:_______________________________Zip Code_________
Phone Number:______________________________________ Email Address:________________________________________________
Signature:_______________________________________________________________ Date:______________________________________
Please complete this form either electronically or by hand after printing and email to duggandds@gmail.com or if printed, scan and email or FAX it back to the
number given above, to confirm receipt and enrollment. Thank you.