REGULATIONS
Vol. 27 Iss. 25 - August 15, 2011

TITLE 18. PROFESSIONAL AND OCCUPATIONAL LICENSING
BOARD OF OPTOMETRY
Chapter 20
Forms

Title of Regulation: 18VAC105-20. Regulations Governing the Practice of Optometry.

Agency Contact: Elaine J. Yeatts, Agency Regulatory Coordinator, Department of Health Professions, 9960 Mayland Drive, Suite 300, Richmond, VA 23233, telephone (804) 367-4688, FAX (804) 524-4434, or email elaine.yeatts@dhp.virginia.gov.

NOTICE: The following forms used in administering the regulation were 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 to access a form. The forms are also available through the agency contact or at the Office of the Registrar of Regulations, General Assembly Building, 2nd Floor, Richmond, Virginia 23219.

FORMS (18VAC105-20)

Application Instructions for Licensure/TPA Certification (rev. 7/08).

Form A, Application for a License to Practice Optometry or TPA Certification (rev. 7/08).

Diagnostic Pharmaceutical Agents Endorsement Application (rev. 7/08).

Professional Designation Application (rev. 7/08).

Professional Designation Application Letter (rev. 3/05).

Professional Designation Application Letter (rev. 7/08).

Application for Reinstatement (rev. 7/08).

Form B, Licensure Verification (rev. 7/08).

Application for Registration for Volunteer Practice (9/07).

Sponsor Certification for Volunteer Registration (9/07).

Form C, Approved Graduate Optometric Programs (12/06).

Form D, Certificate of Training (rev. 7/08).

VA.R. Doc. No. R11-2941; Filed July 27, 2011, 1:48 p.m.