- My TMB |
- Contact Us |
-
-
“... st by submitting a completed Application Withdraw Form to Compact-General@tmb.state.tx.us. Once that has been received and processed, you can submit your application through the IMLCC. ”
“... equest a waiver
The Electronic Prescribing Waiver form is available for submission through your MyTMB account.
Verification of an approved waiver will be displayed on the physician profile once granted.
Once approved, waivers will be issued for a period of one year.
Physicians may app ... ”
“DIRECT DEPOSIT FORM 74-176
PAYEE CHANGE FORM 74-157
APPLICATION FOR TX ID NUMBER ”
“... ;
Acudetox Continuing Education Exemption Request Form ”
“... Pain Management Gold Designated Application Form and submit it along with the requested additional documentation:
Medical Home Agreement – provide a copy of the Medical Home Agreement, written collaborative, coordinated care agreement or memor ... ”
Description: Medical Board 2012 - August - Full Board Committee Meeting Minutes
Document: Texas Medical Board
BOARD MEETING AUGUST 31, 2012 333 GUADALUPE, TOWER 2, SUITE 225 AUSTIN, TEXAS The meeting was called to order on August 31, 2012 at 8:08 a.m. by Irvin E. Zeitler, Jr., D.O., Board President. Board members present were Melinda McMichael, M.D., Vice-President; Paulette Southard, Se ...
Description: Medical Board 2012 - August - Licensure Committee Meeting Minutes
Document: ... mittee was supportive of the stakeholders plan to form a working group to create standard processes and common terminology regarding actions taken.
Dr. Crocker left the meeting at 4:20 p.m.
Agenda Item 9 - Discussion, recommendation, and possible action regarding licensure and registration forms. ...
Description: Medical Board 2012 - August - Licensure Committee - Agenda Item 7b: Proposed Changes to Board Rule 171
Document: ... ysician of the postgraduate training program on a form provided by the board that certifies that: (I) the program meets the definition of an approved postgraduate training program in subsection (a)(1), (a)(2), and (a)(4) of this section; (II) the applicant has met all educational and character requi ...
Description: Medical Board 2012 - August - Disciplinary Process Review Committee - Agenda Item 02 - TX PHP Report
Document: ... 0 [stands] and I have not consumed alcohol in any form since that date. Participant explained that the only thing outside the normal routine was for a certain dish and latte at W hole Foods Market but was told there was no alcohol and couldnt tell whether there was. No prior positive results. A Peth ...
Description: Medical Board 2012 - February - Full board Committee Meeting Minutes
Document: ... on, and possible action regarding autopsy consent form per HB 1009. Dr. Gage-White presented an autopsy consent form per HB1009 with suggested revisions. After discussion, Ms. Southard moved, Dr. Crocker seconded, and the motion passed to recommend the revised autopsy consent form with the addendum ...
Description: Medical Board 2012 - February - Licensure Committee Meeting Minutes
Document: ...
The Committee then discussed proposed changes to Form W of the physician licensure application to clarify Reporting requirements on mental, physical, and neurological conditions. Dr. Smythe moved to recommend to the full Board that the proposed changes to Form W be accepted. Dr. Zeitler seconded. A ...
Description: Medical Board 2012 - February - Licensure Committee - Agenda Item 7a & 7b: Proposed changes to Board Rule 163
Document: ... n submitted directly from the medical school on a form provided to the applicant by the board. The applicant shall attach a recent photograph, meeting United States Government passport standards, to the form before submitting to the medical school. The school shall have the Dean of the medical schoo ...
Description: Medical Board 2012 - February - Licensure Committee - Agenda Item 7c: Proposed changes to Board Rule 171
Document: ... uspended for cause, revoked or subject to another form of discipline in a state or territory of the United States, a province of Canada, or a uniformed service of the United States; (B) an investigation or proceeding pending against the applicant for the restriction, cancellation, suspension, revoca ...
Description: Medical Board 2012 - February - Licensure Committee - Agenda Item 7d: Proposed changes to Board Rule 175
Document: ... ensure fees or penalties must be submitted in the form of a money order, personal check, or cashier's check payable on or through a United States bank. Fees and penalties cannot be refunded except as provided in subsection (c) of this section. If a single payment is made for more than one individual ...
Description: Medical Board 2012 - February - Licensure Committee - Agenda Item 7f: 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 ...
Description: Medical Board 2012 - June - Full board Committee Meeting Minutes
Document: ... cted staff to publish an article in the quarterly newsletter regarding the treatment of chronic pain. Thomas Simons present oral comments on physician residency programs for foreign educated physicians. There board recessed for lunch. The board reconvened and a quorum was confirmed. Agenda item #12, ...
Description: Medical Board 2012 - June - Licensure Committee - Agenda Item 5a and 5b: Proposed Changes to Board Rule 163
Document: ... ) Copy of a current Permanent Resident Card. (ii) Form I-797 Welcome Notice indicating approval of Form I-485 (permanent residence application).
(iii) I-551 stamp in the applicants passport, indicating temporary evidence of LPR status while waiting on issuance of the Permanent Residence card. (iv) ...
Description: Medical Board 2012 - November - Full Board Committee Meeting Minutes
Document: ... ease. The agency was asked to put a notice in the newsletter, however, the agency currently has no policy in place allowing private CME to be advertised in the newsletter. After discussion, the board directed staff not to allow private advertising for CME in the newsletter or the agency website. Age ...
Description: Medical Board 2012 - November - Licensure Committee Meeting Minutes
Document: ... d clarify the existing language on the evaluation form to ensure evaluators understand only the actual form is considered confidential and any additional information collected may be used as evidence and released to the applicant. Staff should also draft a sample waiver form for the evaluators to al ...
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 ...
“... this time, only physician applicants can use the Form Y to expedite an application. Should this change, notification will be posted. ”
Can I expedite my physician assistant application?
At this time, only physician applicants can use the Form Y to expedite an application. Should this change, notification will be posted.
“... cant. Applicants can find the appropriate request form on our website at Supplemental Forms "Form N". ”
My licensing analyst informed me that I need a foreign education evaluation. What do I need to do?
A foreign education evaluation is one tool the board uses in evaluating the medical education of a physician applicant who attended a medical school located outside the United States. The board will accept evaluations from the Foreign Credentials Service of America (FCSA). The cost of the evaluation is borne by the applicant. Applicants can find the appropriate request form on our website at Supplemental Forms "Form N".
“... ird party identification number or choose another form of payment. ”
Can my residency program (or other third party) pay my PIT application fee?
Yes. They must register with the TMB for bulk payment processing. Your program will receive a third party identification number which they should make available to you, if they wish to pay your application fee. On the payment page of the online application, select "Pay by Third Party Payment". Enter the third party identification number you were given in the "Third Party ID" field. Note: This number should not be confused with the TMB personal identification number, or your ACGME, AOA, or TMB Program Identification number. Be sure to enter a valid email address. You will receive an email if the application fee has not been paid within seven days. Your application will not be submitted to the Texas Medical Board until the fee has been paid. Entering an incorrect third party identification number will mean that your program, or other third party payer, is prevented from paying for your application, and you will have to submit a new application with the correct third party identification number or choose another form of payment.
“... your request, a completed Name Change Application form and a notarized copy of the legal document(s) that granted your name change, i.e. marriage license, divorce decree etc. ”
What do I need to do to change the name I use professionally?
You must provide us with a statement that gives an explanation of your request, a completed Name Change Application form and a notarized copy of the legal document(s) that granted your name change, i.e. marriage license, divorce decree etc.
“... cannot use the online system, a Change of Address form is available, but not required. Information on the new Change of Address system is available at: http://www.tmb.state.tx.us/page/change-address ”
Can I give my change of address over the phone?
No. However, changes in mailing or practice addresses can now be updated online in most situations. For those license types that cannot use the online system, a Change of Address form is available, but not required. Information on the new Change of Address system is available at: http://www.tmb.state.tx.us/page/change-address
“... at least 5 working days for the processing of the form, the fee and posting to the computer system. ”
Is the registration payment due before the expiration of a license?
Yes. The completed registration application and payment are due on or before the expiration date of the permit. However, you should allow at least 5 working days for the processing of the form, the fee and posting to the computer system.
“... ensees who choose to register through a hard copy form, when an online option is available. If an online option is not available (ex: license is delinquent or suspended at the time of registration) the additional processing fee will not be required. ”
Is it the same price to register online or by hard copy?
No. An additional processing fee of $50 will be charged to those licensees who choose to register through a hard copy form, when an online option is available. If an online option is not available (ex: license is delinquent or suspended at the time of registration) the additional processing fee will not be required.
“... istration, please submit a hard copy registration form with the correct pro-rated fee. Please note that payments for the incorrect OBA pro-rated fee will be voided, causing a delay in the registration process. You may email us to request a pro-rated registration form at registrations@tmb ... ”
How much does OBA registration cost?
The biennial registration fee for office-based anesthesia is a total of $210, per physician and should be combined with the biennial registration.
For off cycle OBA registration, please submit a hard copy registration form with the correct pro-rated fee. Please note that payments for the incorrect OBA pro-rated fee will be voided, causing a delay in the registration process. You may email us to request a pro-rated registration form at registrations@tmb.state.tx.us.
“... lity. A physician must report on the registration form if she or he has completed the required CME. However, newly licensed physicians are exempt from the CME requirements the first time they register. ”
Is a physician required to complete CME to register a license?
Yes. Physicians need to complete at least 24 hours of continuing medical education each year, at least half of which must be in formal courses. One hour of formal CME must be in medical ethics and/or professional responsibility. A physician must report on the registration form if she or he has completed the required CME. However, newly licensed physicians are exempt from the CME requirements the first time they register.
“... fax). Please use the PMC change of address form located here. ”
How do I submit a name change or change of address for my pain management clinic?
A name change or change of address for a registered pain management clinic must be submitted in writing (by mail or fax). Please use the PMC change of address form located here.
“... d directly to the state board of your request.The form is avaliable under Verification Request in the "Licensee Resources" section of our website. ”
How do I get a verification of my Texas license sent to another state?
Upon written request TMB will provide a state board verification to another state board regarding licensees. The verification includes: licensee's name, license or permit number, issue date, expiration date, disciplinary status, and our board seal will be affixed.
There is no fee for state board verifications. Please allow 10 working days to process your verification. The verification will be mailed directly to the state board of your request.
The form is avaliable under Verification Request in the "Licensee Resources" section of our website.
“... to set up an e-prescribing process. On the waiver form, you will have to specify any of the above categories you are experiencing. ”
How do I qualify for the waiver?
There are three different ways you can qualify for a waiver. If you or your practice is experiencing any of the following, you may qualify for a waiver:
On the waiver form, you will have to specify any of the above categories you are experiencing.