REGULATIONS
Vol. 37 Iss. 13 - February 15, 2021

TITLE 18. PROFESSIONAL AND OCCUPATIONAL LICENSING
BOARD OF MEDICINE
Chapter 110
Forms

REGISTRAR'S NOTICE: Forms used in administering the regulation have been filed by the agency. The forms are not being published; however, online users of this issue of the Virginia Register of Regulations may click on the name of a form with a hyperlink to access it. The forms are also available from the agency contact or may be viewed at the Office of the Registrar of Regulations, 900 East Main Street, 11th Floor, Richmond, Virginia 23219.

Title of Regulation: 18VAC85-110. Regulations Governing the Practice of Licensed Acupuncturists.

Agency Contact: Elaine J. Yeatts, Agency Regulatory Coordinator, Board of Medicine, 9960 Mayland Drive, Suite 300, Richmond, VA 23233, telephone (804) 367-4688, or email elaine.yeatts@dhp.virginia.gov

FORMS (18VAC85-110)

Instructions and Application for a License to Practice as an Acupuncturist - Graduates of Approved Institutions or Programs in the United States (rev. 11/10).

Instructions and Application for a License to Practice as an Acupuncturist - Graduates of Nonapproved Educational Programs (rev. 11/10).

Instructions for Completing an Application as an Acupuncturist in Virginia (rev. 3/2017)

Form A, Claims History (rev. 11/2010)

Form B, Activity Questionnaire (rev. 11/10).

Form B, Employment History (rev. 7/2017)

Form C, Clearance from Other State Boards (rev. 11/2010)

Form L, Certification of Professional Education (rev. 11/10).

Form L, Certification of Professional Education (rev. 8/2007)

Verification of NCCAOM Certification (rev. 3/2008)

Recommendation for Examination by a Physician (rev. 11/2006)

Application for Registration for Volunteer Practice (rev. 8/07).

Sponsor Certification for Volunteer Registration (rev. 8/08).

Instructions and Application for Reinstatement as a Licensed Acupuncturist (rev. 2/09).

Instructions for Completing a Reinstatement Application for Licensed Acupuncturist after Suspension, Surrender, or Mandatory Suspension (rev. 3/10).

Application for Reinstatement of a License to Practice as a Licensed Acupuncturist after Suspension, Surrender, or Mandatory Suspension (rev. 3/10).

Application for Registration for Volunteer Practice (rev. 8/2015)

Sponsor Certification for Volunteer Registration (rev. 3/2018)

Instructions and Application for Reinstatement of an Acupuncture Licensure (rev. 4/2018)

Application to Reactivate an Inactive License for a Licensed Acupuncturist (rev. 1/2018)

VA.R. Doc. No. R21-6637; Filed January 24, 2021