OAR 847-020-0150
Documents and Forms to be Submitted for Licensure

The documents submitted must be legible and no larger than 8 1⁄2” x 11”. All documents and photographs will be retained by the Board as a permanent part of the application file. If original documents are larger than 8 1⁄2” x 11”, the copies must be reduced to the correct size with all wording and signatures clearly shown. Official translations are required for documents issued in a foreign language. The following documents are required:

(1)

Application: Completed formal application provided by the Board. Required dates must include month, day and year.

(2)

Birth Certificate: A copy of birth certificate.

(3)

Medical School Diploma: A copy of a diploma showing graduation from an approved school of medicine or an international school of medicine.

(4)

American Specialty Board Certificate or Recertification Certificate: A copy of the certificate issued by the American Specialty Board in the applicant’s specialty, if applicable.

(5)

Photograph: A close-up, color, passport quality photograph, front view, head and shoulders (not profile), with features distinct, taken within 90 days preceding the filing of the application.

(6)

The results of a Practitioner Self-Query from the National Practitioner Data Bank sent to the Board by the applicant.

(7)

Legible fingerprints as described in 847-008-0068 (State and Nationwide Criminal Records Checks, Fitness Determinations) for the purpose of a criminal records background check.

(8)

An open-book examination on the Medical Practice Act (ORS chapter 677) and Oregon Administrative Rules chapter 847. If an applicant fails the examination three times, the applicant must attend an informal meeting with a Board member, the Executive Director, a Board investigator and/or the Medical Director of the Board to discuss the applicant’s failure of the examination, before being given a fourth and final attempt to pass the examination. If the applicant does not pass the examination on the fourth attempt, the applicant may be denied licensure.

(9)

Any other documentation or explanatory statements as required by the Board.

Source: Rule 847-020-0150 — Documents and Forms to be Submitted for Licensure, https://secure.­sos.­state.­or.­us/oard/view.­action?ruleNumber=847-020-0150.

Last Updated

Jun. 8, 2021

Rule 847-020-0150’s source at or​.us