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International Board for the Certification of Specialists in Oral and Maxillofacial Surgery

  The International Board for the Certification of Specialists in Oral and Maxillofacial Surgery (IBCSOMS) rules and regulations require that an initial credentialing and annual renewal of credentials protocol be conducted to assure the public and profession that you are in good standing in the community and profession. Additionally the IBCSOMS reminds you of your obligation to conduct your professional activities in accordance with the Code of Conduct of the International Board for the Certification of Specialists in Oral and Maxillofacial Surgery. Therefore, the following attestation statement must be completed.

  Therefore, the following attestation statement must be completed. I am confirming my intent to the International Board for the Certification of Specialists in Oral and Maxillofacial Surgery (IBCSOMS) to participate in the Certification and Continuous Improvement in Practices processes and all that this entails. I acknowledge that I begin this process in accordance with the IBCSOMS’ established rules and regulations, guidelines and standards understanding that circumstances may make it necessary to modify the processes which could change the requirements to become certified and/or maintain certification. For the processing of my application and necessary documentation by the Credential Committee of the IBCSOMS, I submit all required fees which are not refundable. In addition, for consideration of my acceptance by the IBCSOMS for examination and/or maintenance, I understand and agree that:

  The IBCSOMS may, at its discretion, investigate my standing and reputation as an oral and maxillofacial surgeon, in the practice of the specialty, including my reputation for complying with the standards of conduct of the specialty, and that this investigation may take place to or subsequent to any examination given to me by the IBCSOMS; and Should the IBCSOMS obtain information that I provided fraudulent information or cheated on any IBCSOMS examination I may be prohibited from ever taking or retaking any IBCSOMS examination, and further should I be a Fellow of the IBCSOMS my certificate will be revoked; and The IBCSOMS may, at its discretion, refuse to examine me, or having examined me may refuse to award a certificate based upon above described investigation, and I understand that said refusal shall be final; and In the event the IBCSOMS refuses to issue a certificate on the basis set forth in subparagraph (3) above, I hereby waive any right I may have to question said refusal in any court of law or equity or other tribunal and further waive any right to a return of any fees; and I am not currently a subject of any disciplinary action by any jurisdictional agency or legal entity. I hereby release, discharge and exonerate the IBCSOMS, its Directors, Officers, Fellows, Examiners, representative and agents from any actions, suits, obligations, damages, claims or demands arising out of, or in connection with, this application, the grade or grades with respect to examinations, and the failure of the IBCSOMS to issue me a certificate. It is understood that the decision whether I am qualified for a certificate rests solely and exclusively in the IBCSOMS and that its decision is final. I also state that I am responsible for the information herein recorded and that all statements are true and accurate.

Note : All communication from the IBCSOMS will be conducted by email. It is your responsibility to notify us if your email address is changed.

I understand and accept the above conditions.

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