Rules and regulations - A hard copy is available from the Board office upon request.  Remember to include your mailing address with your request.

Name Change - Will be made only when a copy of an official document (marriage certificate, divorce decree or court order) is submitted with a letter of request.  The fee for a duplicate license is $5.00 (check or money order) payable to the Commonwealth of PA.

Address change - Written requests should include the old address, new address and license number and social security number.  The Board must be notified within 10 days of any change in address.

Verification of License to Another State - Submit a $15.00 personal check or money order payable to "Commonwealth of PA" for each verification, along with a written request that includes the licensee name, Pennsylvania license number and where the verification is to be sent.
 

OSTEOPATHIC PHYSICIAN AND SURGEON (DO)

Application for Osteopathic Physician Unrestricted License

Application for a Short Term Camp Physician License  

Volunteer License Application

PHYSICIAN ASSISTANT (PAC)

Application for Registration as a Physician Assistant

Application for Registration as a Supervising Physician 

Application for Approval of a Satellite Location

Physician Assistant Supervisor Written Agreement Change Form

Written Agreement - Physician Assistant Prescriptive Authority 

RESPIRATORY THERAPIST (RT)

Application for Licensure as a Respiratory Therapist

ATHLETIC TRAINER (ATC)

Application for Athletic Trainer Licensure

ACUPUNCTURIST

Application for Registration as an Acupunturist

PERFUSIONIST

Application for Perfusionist License

Application for Temporary Graduate Perfusionist License

Application for Temporary Provisional Perfusionist License

Application for Temporary Emergency Perfusionist Registration

REACTIVATION/STATUS CHANGE APPLICATIONS

Physician/Surgeon

Allied Health Professionals

ALL OTHER APPLICATIONS/FORMS

Change of Name and/or Address
Request for Verification/Certification of Licensure and Exam Scores
Application to be Scheduled for the Examination of the Auxiliary Personnel Performing Radiologic Procedures

Application for Voluntary Surrender of License

Questions regarding practice of this profession may be directed to the Office of the State Board: 

Board Administrator, State Board of Osteopathic Medicine, P.O. Box 2649, Harrisburg, PA  17105-2649, (717) 783-4858.  e-mail: ST-OSTEOPATHIC@pa.gov

Board Examination Information:

OSTEOPATHIC DOCTORS

Osteopathic Manipulation Therapy (OMT) Examination: 

For examination application contact:  Professional Credential Services, Inc. (PCS), P.O. Box 198689, Nashville, TN  37219-8689.  Phone 1-877-887-9727.  Completed applications are submitted directly to PCS.  Deadline for accepting completed applications is 60 days prior to date of exam.  Fee is $215.00.  Re-Examinees:  $170.00.   (Fees subject to change.)  

Professional Credential Services, Inc. web address: www.pcshq.com

PHYSICIAN ASSISTANTS

NCCPA Examination:

For examination information contact: National Commission on Certification of Physician Assistants (NCCPA), 12000 Findley Road, Suite 100, Johns Creek, GA  3097.  Phone  678-417-8100; FAX 678-417-8135.  Website: www.nccpa.net

ACUPUNCTURISTS

NCCAOM Certification Examination:

For examination information contact: National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM), 76 South Laura Street, Suite 1290, Jacksonville, FL 32202.  Phone 904-598-1005; FAX 904-598-5001.  Website:  www.nccaom.org

RESPIRATORY THERAPISTS

NBRC Certification Examination:

For examination application information contact: National Board for Respiratory Care (NBRC), 18000 West 105th Street, Olathe, KS 66061-7543.  Phone 913-895-4900; FAX 913-895-4650.  Website: www.nbrc.org

RADIOLOGY EXAMINATION (FOR AUXILIARY PERSONNEL PERFORMING RADIOLOGIC PROCEDURES)

Examination in Radiography
Examination in Nuclear Medicine Technology
Examination in Radiation Therapy Technology
Limited Examination in Radiography - Thorax and Extremities
Limited Examination in Radiography - Skull and Sinuses

Completed applications are submitted directly to the State Board of Osteopathic Medicine, P.O. Box 2649, Harrisburg, PA 17105, FAX 717-787-7769. Fees are subject to change.

Examinations are administered as computer based tests (CBT) with the Pearson VUE.