image of caduceus
Search Term: 'authorization and release form'

E-Prescribing Waiver

“... quirement Effective January 1, 2021, Texas Health and Safety Code, §§481.0755 requires that prescriptions for controlled substances to be issued electronically, except in limited circumstances, or unless a waiver has been granted by the appropriate agency.  A prescription for a contro ... ”

This content is located on the following page(s): Renewal - Electronic Prescribing Waiver

Expert Consultants

“DIRECT DEPOSIT FORM 74-176 PAYEE CHANGE FORM 74-157 APPLICATION FOR TX ID NUMBER ”

This content is located on the following page(s): Expert Consultants

CE for AD Tab 2 - Exemptions

“... *Exemptions are reviewed on a case-by-case basis and must be requested in writing at least 30 days prior to the expiration date of the license.  An exemption may not exceed one registration period, but may be renewed, subject to approval.   Acudetox Continuing Education Exemption Request ... ”

This content is located on the following page(s): CAE for Acudetox Specialists

LMRT Exam FAQs

“... ication to take the LMRT Exam? In order to obtain authorization to attempt passage of the exam, an individual must provide the following documentation:        evidence of current enrollment in an approved limited program and an attestation stating that the individual h ... ”

This content is located on the following page(s): Renewal - LMRT Exams

Gold Designated Practice Status

“A pain management clinic is defined in statute and rule as a publicly or privately-owned facility for which a majority of patients are issued, on a monthly basis, a prescription for opioids, benzodiazepines, barbiturates, or carisoprodol, but not including suboxone.   A pain management clinic m ... ”

This content is located on the following page(s): Gold Designated Practice

Title: Medical Board 2012 - November - Full Board

Description: Medical Board 2012 - November - Full Board Committee Meeting Minutes

Document: ... Shulkin, M M.D.; Stanley y S. Wang, M.D., J.D D.; and Timo othy Webb, J.D. J John D. D Ellis, Jr., J J.D.; Wynne M. Snoots, M.D.; and W W. Roy Smy ythe, M.D. ar rrived a few w minutes after roll call. D David Bauco om; Manuel G. Guajardo o, M.D.; Pa aulette South hard; and Ge eorge Willefo ord III, ...

Click to view in browser - MB-2012-Nov-Full-Board-minutes.pdf
Click to download file

Title: Medical Board 2012 - November - Licensure

Description: Medical Board 2012 - November - Licensure Committee Meeting Minutes

Document: ... Snoots, M.D., Paulette B. Southard, Timothy Webb and Irvin E. Zeitler. Margaret McNeese, M.D. was also present as a resource to the Committee. Agenda Item 2 - Discussion, recommendation, and possible action regarding disciplinary orde rs for falsification. Ms. Robinson reported that although previ ...

Click to view in browser - MB-2012-Nov-licensure-comm.pdf
Click to download file

Title: Medical Board 2012 - November - Licensure Committee - Agenda Item 8b

Description: Medical Board 2012 - November - Licensure Committee - Agenda Item 8b: Proposed Changes to Board Rule 195

Document: ... anagement clinic shall submit an application on a form prescribed by the board. If a clinic has more than one physician owner, then only the medical director must file an application with the board. Certificates issued pursuant to this subsection are not transferable or assignable. If there is more ...

Click to view in browser - MB-2012-Nov-proposed-changes-rule195.pdf
Click to download file

Title: Medical Board 2012 - November - DPRC - Agenda Item 02 - TX PHP Report

Description: Medical Board 2012 - November - Disciplinary Process Review Committee - Agenda Item 02 - TX PHP Report

Document: ... MB 1. 11-0250 Background: X Interim referral and action taken prior to this meeting Referral Type: Self Agreement Term: 5/31/2011 - 5/31/2016 Referral Reason: Substance Sobriety Date: 2/26/2011 Drug(s) of Choice: Alcohol Issue(s): The participant has been discussed at DPRC on two other occasi ...

Click to view in browser - MB-2012-Nov-TX-PHP-Report.pdf
Click to download file

Title: Medical Board 2013 - April - Licensure

Description: Medical Board 2013 - April - Licensure Committee Meeting Minutes

Document: ... .D., Wynne M. Snoots, M.D., Paulette B. Southard, and Timothy Webb. Ms. Southard moved, Mr. Gallardo seconded, that the Committee close the meeting to the public and continue in Executive Session for deliberations concerning Agenda items 2a. The motion passed. Dr. Arambula announced that the meetin ...

Click to download file

Title: Medical Board 2013 - April - DPRC - Agenda Item 02 - TX PHP Report

Description: Medical Board 2013 - April - Disciplinary Process Review Committee - Agenda Item 02 - TX PHP Report

Document: ... cussion 1. 12-0213 License Type: M.D. (Pediatrics and Emergency Medicine) Background: Referral Type: Self Agreement Term: 3/19/2012 3/28/2017 Referral Reason: Substance Sobriety Date: 11/4/2011 Drug(s) of Choice: Alcohol REMAIN WITH PHP X With the understanding that there is zero tolera ...

Click to view in browser - MB-2013-April-TX-PHP-Report.pdf
Click to download file

Title: Medical Board 2013 - February - DPRC

Description: Medical Board 2013 - February - Minutes of the Disciplinary Process Review Committee

Document: ... Scott" Holliday, D.O., Margaret C. McNeese, M.D., and Stanley S. Wang, M.D., M.D. Committee Member Allan Shulkin, M.D., arrived late at approximately10:58 a.m. Committee Member George Willeford III, arrived late at approximately10:59 a.m. Committee Members Patricia S. Blackwell and Irvin E. Zeitler, ...

Click to view in browser - MB-2013-Feb-DPRC-Minutes.pdf
Click to download file

Title: Medical Board 2013 - February - Licensure Committee - Agenda Item 6b: Proposed Changes to Board Rule 172

Description: Medical Board 2013 - February - Licensure Committee - Agenda Item 6b: Proposed Changes to Board Rule 172

Document: ... 2, Part 9 Proposed Changes Chapter 172 Temporary and Limited Licenses Page 1 of 3 Draft January 25, 2013 V2-172 Draft 172.8. Faculty Temporary License. (a) The board may issue a faculty temporary license to practice medicine to a physician in accordance with 155.104, Texas Occupations Code. " ...

Click to download file

Title: Medical Board 2013 - February - Licensure Committee - Agenda Item 6b: Proposed Changes to Board Rule 175

Description: Medical Board 2013 - February - Licensure Committee - Agenda Item 6b: Proposed Changes to Board Rule 175

Document: ... tle 22, Part 9 Proposed Changes Chapter 175 Fees and Penalties Page 1 of 1 Draft January 25, 2013 V2-175 Draft 175.5. Payment of Fees or Penalties. (a) Method of Payment. Fees paid online must be submitted by credit card, electronic check, or debit card, as required by the online application. ...

Click to download file

Title: Medical Board 2013 - February - DPRC - Agenda Item 02 - TX PHP Report

Description: Medical Board 2013 - February - Disciplinary Process Review Committee - Agenda Item 02 - TX PHP Report

Document: ... he slept through the alarm because he had been up and down all night with his wife who was sick. 10/01/2012: Tested "positive" for codeine (2409 ng/mL), morphine (396 ng/mL), methadone (1957 ng/mL), and methadone metabolite (1612 ng/mL). He advised that these are the medications he takes for his per ...

Click to view in browser - MB-2013-Feb-TX-PHP-Report.pdf
Click to download file

Title: Duties of Program Director to Report Form

Description:

Document: ... tors to Report. In accordance with 160.002 and 160.003 of the Act, Program Directors must report the following to the board within 30 days: (1) a PIT permit holder who did not begin the training program for any reason, including failure to graduate from medical school; (2) a PIT permi ...

Click to download file

Title: NCT Documentation Checklist & Eligibility Requirements

Description: NCT Documentation Checklist & Eligibility Requirements

Document: ... submit copy of certificate directly to the TMB and certificate must reflect program completion date. ☐ Program Verification Letter and Certified Transcript Required for NCT applicants who completed a LMRT or MRT program. Program must submit a letter outlining the total number ...

Click to view in browser - NCT Documentation Checklist 01.2025.pdf
Click to download file

Title: IT Qualification Data Sheet

Description: IT Qualification Data Sheet form

Document: Job Title and Number: Programmer IV Job no. 15-503-22 Applicant Name: Click here to enter text. Signature and Date: (Will be signed at interview) 1206503873500 Instructions: Important: Before completing this form, please save document to your local computer using ...

Click to view in browser - TMB-IT-QDS-form.docx
Click to download file

Title: Press Release November 4, 2022

Description: TMB disciplines 14 physicians at October meeting, adopts rule changes

Document: Texas Medical Board Press Release FOR IMMEDIATE RELEASE November 4 , 2022 Media contact: Jarrett Schneider , 512 - 305 - 7018 Customer service: 512 - 305 - 7030 or 800 - 248 - 4062 TMB disciplines 14 physicians at October meeting , adopts rule changes At its October ...

Click to view in browser - pr-20221104.pdf
Click to download file

Title: Press Release November 18, 2022

Description: Texas State Board of Acupuncture Examiners suspends Austin acupuncturist (Jenkins-Bey)

Document: Texas Medical Board Press Release FOR IMMEDIATE RELEASE November 1 8 , 2022 Media contact: Jarrett Schneider, 512 - 305 - 7018 Customer service: 512 - 305 - 7030 or 800 - 248 - 4062 Texas State Board of Acupuncture Examiners suspends Austin acupuncturist ...

Click to view in browser - pr-20221118.pdf
Click to download file

How do I qualify for the waiver?

“... pact of compliance on profitability or viability; and the availability of measures that would mitigate the economic impact of complying. If your practice has technological limitations not reasonably within your control.    Other exceptional circumstances that would lead to you or your pr ... ”