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“... licensees who choose to register through a paper 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.
To request a hard copy registration form, p ... ”
“... licensees who choose to register through a paper 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.
To request a hard copy registration form, p ... ”
“... licensees who choose to register through a paper 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.
To request a hard copy registration form, p ... ”
“... licensees who choose to register through a paper 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.
To request a hard copy registration form, p ... ”
“... tatus, complete and return the retirement request form (link below) to the Board for approval before the expiration date of the current registration permit. Refunds of registration fees already paid cannot be made.
If an acupuncturist is ineligible for retired status, biennial registration, i ... ”
“... licensees who choose to register through a paper 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.
To request a hard copy registration form, p ... ”
“... licensees who choose to register through a paper 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.
To request a hard copy registration form, p ... ”
“... ete and return the voluntary charity care request form (link below) to Board for approval before the expiration date of the current certificate. Refunds of registration fees already paid cannot be made.
If an individual does not qualify for this status, notification will be sent and the bienni ... ”
“... ;
MRT/LMRT Continuing Education Exemption Request Form
· At least 12 (of the 24) hours CE must be satisfied by attendance and participation in formal courses that are designated for Category A or A-plus credits of CE evaluated by an organization reco ... ”
“... ;
MRT/LMRT Continuing Education Exemption Request Form
”
“...
NCT Continuing Education Exemption Request Form ”
“... nbsp; an official continuing education validation form of the sponsoring organization accompanied by a brochure, agenda, program, or other applicable information indicating content of the program; or
4) evidence of registration and attendance at a scientific meeting; and
5) &n ... ”
“... rfusionist Continuing Education Exemption Request Form ”
“...
RCP Continuing Education Exemption Request Form
Those who hold temporary permits are not subject to these continuing education requirements.
”
“... e and return the appropriate cancellation request form (links below) to the Board for approval before the expiration date of the current certificate. Refunds of registration fees already paid cannot be made.
Because these forms must be received by our office before the expiration date of the ... ”
Description: Medical Board 2006 August Executive TEXAS MEDICAL BOARD EXECUTIVE COMMITTEE AUGUST 24, 2006
Document: ... in Relief (Texas State Board of Medical Examiners Newsletter, Vol. 14, No. 1, Spring/Summer 1992, page 1) B. Narcotics and Pain Relief (Texas State Board of Medical Examiners Newsletter, Vol. 14, No. 2, Winter 1992, page 10) C. Pain Control and the Texas State Board of Medical Examiners (Texas State ...
Description: Medical Board 2006 August TEXAS MEDICAL BOARD BOARD MEETING MINUTES August 25, 2006
Document: ... part 5 into part 7, move part 6 and part 7 on the form to become part 5 and 6; change "part 5 above" to "part 7 above"; move signature and acknowledgment to back page; and correct the clerical error relating to mandatory notarization; and that staff be directed to publish the proposed rules in the T ...
Description: Medical Board 2022 - March - Full Board Minutes
Document: ... ng any optical surgical procedures, including any form of eye surgery, laser procedures, intraviscous procedures, or injections12 cycles of chart monitoriand modification may be considered upon completion of an ACGME approved training program after oneyear. Agenda Item #15, Executive Director Report ...
Description: Medical Board 2006 - August - Licensure Committee Meeting Minutes August 26, 2006
Document: ... .5, with the exception of the change to eliminate Form I, as proposed in the Texas Register for public comment. Ms. Attebury seconded. All voted in favor and the motion passed.
Item 12b - Chapter 172.14, Temporary and Limited Licenses, to include the addition of a Limited License for Practice of A ...
Description: Medical Board 2006 - December - Executive Committee December 7, 2006
Document: TEXAS MEDICAL BOARD EXECUTIVE COMMITTEE DECEMBER 7, 2006
The meeting was called to order at 8:35 a.m. by Board President, Roberta Kalafut, D.O. Committee members present were Eddie J. Miles, Jr., Keith E. Miller, M.D.; John W. Pate, Jr., M.D; and Larry Price, D.O. Other Board members present were L ...
Description: Medical Board 2006 - February - Executive Committee February 2, 2006
Document: ... up. After discussion, the Board directed staff to form an Ad Hoc Committee to Study Chapter 192, with Dr. Anderson as the Chair, and Dr. Pate, Dr. Price, and Ms. Southard as committee members.
Agenda item #5, Adjourn. The meeting was adjourned at 9:49 a.m.
...
Description: Medical Board 2006 - February - Full board Committee Meeting Minutes February 2, 2006
Document: ... or, and bring to next Board meeting a simpler new form including the following changes: definition of emancipated minor; require parental consent in person or a notarized signature; have parent/guardian initial each page; provide official translation forms; remove consent for anesthesiology; remove ...
Description: Medical Board 2006 - June - Full board Committee Meeting Minutes June 1, 2006
Document: ... er 170 as published in the Texas Register, and to form a resource group and schedule a meeting with this group to develop a revision to Chapter 170 to be considered at the August Medical Board meeting. 6. Chapter 171, Postgraduate Training Permits, to include clarification of reporting requirements, ...
Description: Medical Board 2006 - October - Minutes of the Diciplinary Process Review Committee October 5, 2006
Document: ... ented the issues. The Committee directed staff to form a Focus Group to consider possible changes to Chapter 164 and 165. Dr. Miller appointed a DPRC Ad Hoc Committee to include Dr. Miller, Dr. Kalafut, Dr. Anderson, Dr. Khan and Mr. Turner to work with staff on possible changes to these rules. Agen ...
Description: FORM D Dean's Certification Texas Medical Board Texas PA Board Texas State Board of Acupuncture Examiners
Document:
LICENSURE APPLICATION FORM D DEAN'S CERTIFICATION
Version
01/2025
Form D
Dean's Certification
Texas Medical Board
Texas PA Board
Texas State Board of Acupuncture Examiners
APPLICANT SECTION
APPLICANT:
Complete this section and t ...
Description: Form G - Provisional License Application and Sponsorship Form
Document: ��FORM Provisional License Application and Sponsorship Form��LICENSURE APPLICATION FORM ROVISIONAL ICENSE PPLICATION AND PONSORSHIP ORMVersion 08/21/14Pay withpersonal check, cashier’s check or money order (payable through a US bank)
_________________________________ ...
Description: Form I - Medical Professional Liability Claims Report
Document: Form I: Medical Professional Liability Claims Report
Texas Medical Board |
Texas PA Board | Texas State
Board of Acupuncture Examiners
LICENSURE APPLICATION FORM I MEDICAL PROFESSIONAL LIABILITY CLAIMS REPORT
Version
01/2025
File one report for each claim/suit
that was reported ...
Description: FORM J Clinical Clerkship Affidavit & Checklist Texas Medical Board
Document: FORM J
LICENSURE APPLICATION FORM J CLINICAL CLERKSHIP AFFIDAVIT & CHECKLIST
Version
08/09/
2010
Page
1
of
4
Clinical Clerkship Affidavit
& Checklist
Texas Medical Board
Required for
all
international medical graduates.
If you don’t me ...
Description: Yes response to any of the questions in the Disciplinary Action History Section
Document: �� FORM S��____________________________________________________________Applicant’s SignatureDate_____________________________________________Printed nameLICENSURE APPLICATION FORM S DISCIPLINARY ACTIONHISTORY ...
Description: Medical Board 2007 - April - Executive Committee April 12, 2007
Document: ... the increased readership of the Board's quarterly newsletter. Dr. Patrick indicated that the newsletter has served to better educate the state's licensees. Dr. Patrick concluded his remarks by discussing Dr. Herb Fred, whose essay in a recent edition of the Board's newsletter resulted in Dr. Fred's ...
“... 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.