offered by
Division of Professional Licensure
Board of Registration in Optometry

Optometrists Applications and Forms

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Table of Contents

Optometrist Applications 
Licensing Benefits for Active Military, Spouses & Veterans 
Optometry Renewal Instructions 
Notice of Office Location (PDF 61.03 KB)
DPA and TPA Certification Information (PDF 18.16 KB)
DPA Certification Application (PDF 24.55 KB)
TPA Certification Application (PDF 20.05 KB)
Sample Rx Check Form - Interactive PDF Version (PDF 117.7 KB)
Sample Rx Check Form (RTF 7.27 KB)
Verification Request (PDF 35.55 KB)
Change of Name or Request for Duplicate License for Board of Registration in Optometry (PDF 54.31 KB)
Health Care Fraud Complaint Application (PDF 23.18 KB)
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