New Anesthesia Permit Application Fee

As a first time anesthesia permit applicant please send Dr. Robbins a copy of the Request for Provisional Permit Form you received from the State Board of Dentistry along with the required 4 application forms. The $275  fee for your application may be paid here online or you may include a check made out to the PA Office Anesthesia Evaluation Program.

If paying by check, please send to the following address:

PSOMS – Anesthesia
c/o Christine Corrigan
PO Box 500
Harrisburg, Pa 17108-0500