Forms on OP's Website

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This is a comprehensive list of the PDF forms available on OP's website, alphabetically by profession. To view or print these forms online, you will need to have the free Adobe Reader installed on your computer.

For a complete description of the requirements to submit an application for a particular profession, click on the profession name. For immediate access to a specific form, click directly on the filename of that form. NOTE: Please read all instructions carefully before completing and submitting forms; the forms required for an application vary depending on an applicant's background.

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Acupuncture

• Acupuncture Form 1 - Application for Licensure (www.op.nysed.gov/acu1.pdf)
• Acupuncture Form 2a - Certification of Pre-professional College/University Education by School Official (www.op.nysed.gov/acu2a.pdf)
• Acupuncture Form 2b - Certification of Professional Acupuncture Education by School Official (www.op.nysed.gov/acu2b.pdf)
• Acupuncture Form 5 - Application for Limited Permit (www.op.nysed.gov/acu5.pdf)

Architecture

• Architecture Form 1 - Application for Licensure (www.op.nysed.gov/arch1.pdf)
• Architecture Form 2 - Certification of Professional Education (www.op.nysed.gov/arch2.pdf)
• Architecture Form 3 - Verification of Out-of-state Licensure, Registration and/or Examination (www.op.nysed.gov/arch3.pdf)
• Architecture Form 4 - Experience Verification (www.op.nysed.gov/arch4.pdf)

Athletic Training

• Athletic Training Form 1 - Application for Certification (www.op.nysed.gov/at1.pdf)
• Athletic Training Form 2 - Certification of Professional Education (www.op.nysed.gov/at2.pdf)
• Athletic Training Form 2b - Certification of Equivalent Practicum Experience (www.op.nysed.gov/at2b.pdf)
• Athletic Training Form 3 - Verification of Other Professional Licensure/Certification (www.op.nysed.gov/at3.pdf)

Audiology

• Speech-Language Pathology and Audiology Form 1 - Application for Licensure (www.op.nysed.gov/sla1.pdf)
• Speech-Language Pathology and Audiology Form 2 - Certification of Professional Education (www.op.nysed.gov/sla2.pdf)
• Speech-Language Pathology and Audiology Form 4a - Identification of Supervisor and Setting (www.op.nysed.gov/sla4a.pdf)
• Speech-Language Pathology and Audiology Form 4b - Record of Supervised Experience (www.op.nysed.gov/sla4b.pdf)

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Certified Shorthand Reporting

• Certified Shorthand Reporting Form 1 - Application for Licensure (www.op.nysed.gov/csr1.pdf)
• Certified Shorthand Reporting Form 2 - Certification of Education (www.op.nysed.gov/csr2.pdf)
• Certified Shorthand Reporting Form 4 - Certification of Experience (www.op.nysed.gov/csr4.pdf)

Chiropractic

• Chiropractic Form 1 - Application for Licensure (www.op.nysed.gov/chiro1.pdf)
• Chiropractic Form 2 - Certification of Education (www.op.nysed.gov/chiro2.pdf)
• Chiropractic Form 3 - Verification of Chiropractic Licensure in Another Jurisdiction (www.op.nysed.gov/chiro3.pdf)
• Chiropractic Form 4 - Verification of Experience (www.op.nysed.gov/chiro4.pdf)

Clinical Laboratory Technology

• Clinical Laboratory Technologist & Clinical Laboratory Technician

  • Clinical Laboratory Technologist/Technician Form 1 - Application for Licensure (www.op.nysed.gov/clt1.pdf)
  • Clinical Laboratory Technologist/Technician Form 2 - Certification of Professional Education (www.op.nysed.gov/clt2.pdf)
  • Clinical Laboratory Technologist/Technician Form 3 - Verification of Other Professional Licensure/Certification (www.op.nysed.gov/clt3.pdf)
  • Clinical Laboratory Technologist/Technician Form 4 - Applicant Experience Record (For Grandparenting Applicants Only) (www.op.nysed.gov/clt4.pdf)
  • Clinical Laboratory Technologist/Technician Form 4A - Certification of Experience (For Grandparenting Applicants Only) (www.op.nysed.gov/clt4a.pdf)
  • Clinical Laboratory Technologist/Technician Form 4B - Certification of Faculty Member/Managing Administrator Status (For Clinical Laboratory Technologist Applicants Using Grandparenting Method Four Only) (www.op.nysed.gov/clt4b.pdf)
  • Clinical Laboratory Technologist/Technician Form 5 - Application for Limited Permit (www.op.nysed.gov/clt5.pdf)
  
  

• Cytotechnologist

  • Cytotechnologist Form 1 - Application for Licensure (www.op.nysed.gov/cyt1.pdf)
  • Cytotechnologist Form 2 - Certification of Professional Education (www.op.nysed.gov/cyt2.pdf)
  • Cytotechnologist Form 3 - Verification of Other Professional Licensure/Certification (www.op.nysed.gov/cyt3.pdf)
  • Cytotechnologist Form 4 - Applicant Experience Record (For Grandparenting Applicants Only) (www.op.nysed.gov/cyt4.pdf)
  • Cytotechnologist Form 4A - Certification of Experience (For Grandparenting Applicants Only) (www.op.nysed.gov/cyt4a.pdf)
  • Cytotechnologist Form 5 - Application for Limited Permit (www.op.nysed.gov/cyt5.pdf)

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Dentistry

• Certified Dental Assistant

  • Certified Dental Assisting Form 1 - Application for Licensure (www.op.nysed.gov/cda1.pdf)
  • Certified Dental Assisting Form 2 - Certification of Professional Education (www.op.nysed.gov/cda2.pdf)
  • Certified Dental Assisting Form 5 - Application for Limited Permit (www.op.nysed.gov/cda5.pdf)
  
  

• Dental Hygienist

  • Dental Hygiene Form 1 - Application for Licensure (www.op.nysed.gov/dh1.pdf)
  • Dental Hygiene Form 2 - Certification of Professional Education (www.op.nysed.gov/dh2.pdf)
  • Dental Hygiene Form 3 - Certification of Licensure (www.op.nysed.gov/dh3.pdf)
  • Dental Hygiene Form 4a - Personal Affidavit of Professional Practice for Endorsement Applicants (www.op.nysed.gov/dh4a.pdf)
  • Dental Hygiene Form 4b - Verification of Professional Practice (www.op.nysed.gov/dh4b.pdf)
  • Dental Hygiene Form 1LL - Application for a Three-Year Limited License and Extension (www.op.nysed.gov/dent1ll.pdf)
  • Dental Hygiene Limited License - Affidavit of Agreement (www.op.nysed.gov/dentllaoa.pdf)
  • Dental Hygiene Restricted Local Infiltration Anesthesia/Nitrous Oxide Analgesia Certification - Application (www.op.nysed.gov/dha1.pdf)
  • Dental Hygiene Restricted Local Infiltration Anesthesia/Nitrous Oxide Analgesia Certification - Verification of Education (www.op.nysed.gov/dha2.pdf)
  
  

• Dentist

  • Dentist Form 1 - Application for Licensure (www.op.nysed.gov/dent1.pdf)
  • Dentist Form 2 - Certification of Professional Education (www.op.nysed.gov/dent2.pdf)
  • Dentist Form 3 - Certification of Licensure (www.op.nysed.gov/dent3.pdf)
  • Dentist Form 4 - Personal Affidavit of Professional Practice (www.op.nysed.gov/dent4.pdf)
  • Dentist Form 4a - Supporting Affidavit of Professional Practice (www.op.nysed.gov/dent4a.pdf)
  • Dentist Form 4b - Certification of Clinical Residency Program Completion (www.op.nysed.gov/dent4b.pdf)
  • Dentist Form 5 - Application for a Limited Permit in Dentistry (www.op.nysed.gov/dent5.pdf)
  • Dentist Form 1LL - Application for a Three-Year Limited License and Extension (www.op.nysed.gov/dent1ll.pdf)
  • Dentist Limited License - Affidavit of Agreement (www.op.nysed.gov/dentllaoa.pdf)
  • Dentist Form 1AC-R - Certification to Use Acupuncture (www.op.nysed.gov/acupuncert1.pdf)
  • Dentist Form 2AC - Certification of Acupuncture Education (www.op.nysed.gov/acupuncert2.pdf)
  
  

• Dental Anesthesia Certification (for licensed dentists only)

  • Dental Anesthesia Form 1 - Application for Dental Anesthesia/Sedation Certification (www.op.nysed.gov/dentanes1.pdf)
  • Dental Anesthesia Forms 2 A, B and C - Verification of Program Completion
    • www.op.nysed.gov/dentanes2a.pdf - for a General Anesthesia Certificate
    • www.op.nysed.gov/dentanes2b.pdf - for a Parenteral Conscious Sedation Certificate
    • www.op.nysed.gov/dentanes2c.pdf - for an Enteral Conscious Sedation Certificate

Dietetics and Nutrition

• Dietetics and Nutrition Form 1 - Application for Licensure (www.op.nysed.gov/diet1.pdf)
• Dietetics and Nutrition Form 2 - Cerification of Professional Education (www.op.nysed.gov/diet2.pdf)
• Dietetics and Nutrition Form 3E - Certification of Dietetics-Nutrition Examination Results (www.op.nysed.gov/diet3e.pdf)
• Dietetics and Nutrition Form 4 - Applicant Professional Experience Record for all applicants (www.op.nysed.gov/diet4.pdf)
• Dietetics and Nutrition Form 4B - Report of Experience for Associate degree applicants only (www.op.nysed.gov/diet4b.pdf)
• Dietetics and Nutrition Form 4C - Report of Planned Work Experience for all applicants (www.op.nysed.gov/diet4c.pdf)
• Dietetics and Nutrition Form 4E - Endorsement by an Acceptable Dietitian-Nutritionist (www.op.nysed.gov/diet4e.pdf)

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Engineering

• Engineering Form 1 - Application for Licensure (www.op.nysed.gov/pe1.pdf)
• Engineering Form 2 - Certification of Education (www.op.nysed.gov/pe2.pdf)
• Engineering Form 3 - Verification of Out-of-State Licensure, Examination and/or Education (www.op.nysed.gov/pe3.pdf)
• Engineering Form 4 - Report of Professional Experience (RPE) (www.op.nysed.gov/pe4.pdf)
• Engineering Form 4a - Report of Professional Experience (RPE) Continuation Sheet (www.op.nysed.gov/pe4a.pdf)
• Engineering Form 5 - Notification of Intent to Practice Professional Engineering Under Section 7208(b) of the Education Law (www.op.nysed.gov/pe5.pdf)

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Interior Design

• Interior Design Form 1 - Application for Licensure (www.op.nysed.gov/intdesform1.pdf)
• Interior Design Form 2 - Certification of Professional Education (www.op.nysed.gov/intdesform2.pdf)
• Interior Design Form 4 - Report of Professional Experience (www.op.nysed.gov/intdesform4.pdf)
• Interior Design Form 4a - Verification of Experience (www.op.nysed.gov/intdesform4a.pdf)

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Landscape Architecture

• Landscape Architecture Form 1 - Application for Licensure (www.op.nysed.gov/landarch1.pdf)
• Landscape Architecture Form 2 - Certification of Education (www.op.nysed.gov/landarch2.pdf)
• Landscape Architecture Form 3 - Verification of Out-of-state Licensure, Registration and/or Examination (www.op.nysed.gov/landarch3.pdf)
• Landscape Architecture Form 4 - Verification of Experience (www.op.nysed.gov/landarch4.pdf)

Land Surveying

• Land Surveying Form 1 - Application for Licensure (www.op.nysed.gov/lsurv1.pdf)
• Land Surveying Form 2 - Certification of Education (www.op.nysed.gov/lsurv2.pdf)
• Land Surveying Form 3 - Verification of Out of State Licensure, Registration and/or Examination (www.op.nysed.gov/lsurv3.pdf)
• Land Surveying Form 4 - Report of Professional Experience (RPE) (www.op.nysed.gov/lsurv4.pdf)
• Land Surveying Form 4c - Report of Professional Experience (RPE) Continuation Sheet (www.op.nysed.gov/lsurv4c.pdf)
• Land Surveying Form 5 - Notification of Intent to Practice Land Surveying Under Section 7208(b) of Education Law (www.op.nysed.gov/lsurv5.pdf)

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Massage Therapy

• Massage Therapy Form 1 - Application for Licensure (www.op.nysed.gov/mt1.pdf)
• Massage Therapy Form 2 - Certification of Professional Education (www.op.nysed.gov/mt2.pdf)
• Massage Therapy Form 3 - Certification of Massage Therapist Licensure in Another Jurisdiction (www.op.nysed.gov/mt3.pdf)
• Massage Therapy Form 4 - Candidate Professional Experience Record (www.op.nysed.gov/mt4.pdf)
• Massage Therapy Form 4b - Verification of Experience (www.op.nysed.gov/mt4b.pdf)
• Massage Therapy Form 5 - Application for Limited Permit in Massage Therapy (www.op.nysed.gov/mt5.pdf)

Medical Physics

• Medical Physics Form 1 - Application for Licensure (www.op.nysed.gov/mp1.pdf)
• Medical Physics Form 2 - Certification of Professional Education (www.op.nysed.gov/mp2.pdf)
• Medical Physics Form 4 - Personal Affidavit of Professional Practice (www.op.nysed.gov/mp4.pdf)
• Medical Physics Form 4A - Verification of Professional Practice (www.op.nysed.gov/mp4a.pdf)
• Medical Physics Form 5 - Application for Limited Permit (www.op.nysed.gov/mp5.pdf)

Medicine

• Physician

  • Medicine Form 1 - Application for Licensure (www.op.nysed.gov/med1.pdf)
  • Medicine Form 2 - Certification of Professional and Pre-professional Education (www.op.nysed.gov/med2.pdf)
  • Medicine Form 2cc - Certification of Approved Clinical Clerkship (www.op.nysed.gov/med2cc.pdf)
  • Medicine Form 2pgt - Certification of Approved Postgraduate Training (www.op.nysed.gov/med2pgt.pdf)
  • Medicine Form 3a - Verification of Medical Licensure in Another Country (www.op.nysed.gov/med3a.pdf)
  • Medicine Form 3b - Verification of pre-1972 Licensure in Another State (www.op.nysed.gov/med3b.pdf)
  • Medicine Form 4 - Verification of Professional Practice of Medicine in Another Jurisdiction (www.op.nysed.gov/med4.pdf)
  • Medicine Form 5a - Application for Limited Permit in Medicine for Applicants Seeking Licensure in New York State (www.op.nysed.gov/med5a.pdf)
  • Medicine Form 5b - Application for Limited Permit for Applicants Not Seeking Licensure in New York State (www.op.nysed.gov/med5b.pdf)
  • Medicine - Certification of Fifth (5th) Pathway Program (www.op.nysed.gov/med5th.pdf)
  • Medicine - Application for a Three Year Limited License (www.op.nysed.gov/med1ll.pdf)
  • Medicine - Three Year Limited License - Affidavit of Agreement (www.op.nysed.gov/medll-affidavit.pdf)
  • Medicine - Request for Status Report of ECFMG Certification (www.ecfmg.org/cvs/forms/282asb.pdf)
  • Medicine Form 1AC-R - Certification to Use Acupuncture (www.op.nysed.gov/acupuncert1.pdf)
  • Medicine Form 2AC - Certification of Acupuncture Education (www.op.nysed.gov/acupuncert2.pdf)
  
  

• Physician Assistant

  • Physician Assistant Form 1 - Application for Licensure (www.op.nysed.gov/pa1.pdf)
  • Physician Assistant Form 2 - Certification of Professional Education (www.op.nysed.gov/pa2.pdf)
  • Physician Assistant Form 3 - Verification of Licensure/Certification in Another Jurisdiction (www.op.nysed.gov/pa3.pdf)
  • Physician Assistant Form 5 - Application for Limited Permit (www.op.nysed.gov/pa5.pdf)
  
  

• Specialist Assistant

  • Specialist Assistant Form 1 - Application for Licensure (www.op.nysed.gov/sa1.pdf)
  • Specialist Assistant Form 2 - Certification of Professional Education (www.op.nysed.gov/sa2.pdf)
  • Specialist Assistant Form 4 - Certification of Experience (www.op.nysed.gov/sa4.pdf)

Mental Health Practitioners

• Creative Arts Therapy

  • Creative Arts Therapy Form 1 - Application for Licensure (www.op.nysed.gov/cat1.pdf)
  • Creative Arts Therapy Form 2 - Certification of Professional Education (www.op.nysed.gov/cat2.pdf)
  • Creative Arts Therapy Form 3 - Verification of Other Professional Licensure/Certification (www.op.nysed.gov/cat3.pdf)
  • Creative Arts Therapy Appendix A - Requirements for Supervised Experience (www.op.nysed.gov/catapa.pdf)
  • Creative Arts Therapy Form 4 - Applicant Experience and Endorsement Record (www.op.nysed.gov/cat4.pdf)
  • Creative Arts Therapy Form 4B - Certification of Supervised Experience (www.op.nysed.gov/cat4b.pdf)
  • Creative Arts Therapy Form 5 - Application for Limited Permit (www.op.nysed.gov/cat5.pdf)
  
  

• Marriage and Family Therapy

  • Marriage and Family Therapy Form 1 - Application for Licensure (www.op.nysed.gov/mft1.pdf)
  • Marriage and Family Therapy Form 2 - Certification of Professional Education (www.op.nysed.gov/mft2.pdf)
  • Marriage and Family Therapy Form 3 - Verification of Other Professional Licensure/Certification (www.op.nysed.gov/mft3.pdf)
  • Marriage and Family Therapy Appendix A - Requirements for Supervised Experience (www.op.nysed.gov/mftapa.pdf)
  • Marriage and Family Therapy Form 4 - Applicant Experience and Endorsement Record (www.op.nysed.gov/mft4.pdf)
  • Marriage and Family Therapy Form 4B - Certification of Supervised Experience (www.op.nysed.gov/mft4b.pdf)
  • Marriage and Family Therapy Form 5 - Application for Limited Permit (www.op.nysed.gov/mft5.pdf)
  
  

• Mental Health Counseling

  • Mental Health Counseling Form 1 - Application for Licensure (www.op.nysed.gov/mhc1.pdf)
  • Mental Health Counseling Form 2 - Certification of Professional Education (www.op.nysed.gov/mhc2.pdf)
  • Mental Health Counseling Form 3 - Verification of Other Professional Licensure/Certification (www.op.nysed.gov/mhc3.pdf)
  • Mental Health Counseling Appendix A - Requirements for Supervised Experience (www.op.nysed.gov/mhcapa.pdf)
  • Mental Health Counseling Form 4 - Applicant Experience and Endorsement Record (www.op.nysed.gov/mhc4.pdf)
  • Mental Health Counseling Form 4B - Certification of Supervised Experience (www.op.nysed.gov/mhc4b.pdf)
  • Mental Health Counseling Form 5 - Application for Limited Permit (www.op.nysed.gov/mhc5.pdf)
  
  

• Psychoanalysis

  • Psychoanalysis Form 1 - Application for Licensure (www.op.nysed.gov/psyanl1.pdf)
  • Psychoanalysis Form 2 - Certification of Professional Education (www.op.nysed.gov/psyanl2.pdf)
  • Psychoanalysis Form 2A - Certification of Graduate Study (www.op.nysed.gov/psyanl2a.pdf)
  • Psychoanalysis Form 3 - Verification of Other Professional Licensure/Certification (www.op.nysed.gov/psyanl3.pdf)
  • Psychoanalysis Appendix A - Requirements for Supervised Experience (www.op.nysed.gov/psyanlapa.pdf)
  • Psychoanalysis Form 4 - Applicant Experience and Endorsement Record (www.op.nysed.gov/psyanl4.pdf)
  • Psychoanalysis Form 4B - Certification of Supervised Experience (www.op.nysed.gov/psyanl4b.pdf)
  • Psychoanalysis Form 5 - Application for Limited Permit (www.op.nysed.gov/psyanl5.pdf)
  
  

Midwifery

• Midwifery Form 1 - Application for Licensure (www.op.nysed.gov/mid1.pdf)
• Midwifery Form 2 - Certification of Professional Education (www.op.nysed.gov/mid2.pdf)
• Midwifery Form 2A - Certification Of Pharmacology Course or the Equivalent of Not Less Than Three Semester Hours (www.op.nysed.gov/mid2a.pdf)
• Midwifery Form 2B - Certification of Instruction in New York State and Federal Laws Relating to Prescriptions and Record Keeping (www.op.nysed.gov/mid2b.pdf)
• Midwifery Form 5 - Application for Limited Permit (www.op.nysed.gov/mid5.pdf)

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Nursing

• Registered Professional Nurse and Licensed Practical Nurse

  • Nursing Form 1 - Application for Licensure (www.op.nysed.gov/nurse1.pdf)
  • Nursing Form 2 - Certification of Professional Education (www.op.nysed.gov/nurse2.pdf)
  • Nursing Form 2AF - Certification Of Equivalent U.S. Armed Forces Education For LPN Licensure (www.op.nysed.gov/nurse2af.pdf)
  • Nursing Form 3 - Certification of Approval of Nursing Program and/or License Status or Licensing Examination Results (www.op.nysed.gov/nurse3.pdf)
  • Nursing Form 5 - Application for a Limited Permit (www.op.nysed.gov/nurse5.pdf)
  
  

• Nurse Practitioner

  • Nurse Practitioner Form 1 - Application for Licensure (www.op.nysed.gov/np1.pdf)
  • Nurse Practitioner Form 2 - Certification of Professional Education - (www.op.nysed.gov/np2.pdf)
  • Nurse Practitioner Form 2B - Verification of Instruction in New York State and Federal Laws Related to Prescriptions and Record Keeping. - (www.op.nysed.gov/np2b.pdf)
  • Nurse Practitioner Form 2C - Verification of Pharmacotherapeutics Course - (www.op.nysed.gov/np2c.pdf)
  • Nurse Practitioner Form 3 - Verification of National Nurse Practitioner Examination - (www.op.nysed.gov/np3.pdf)
  • Nurse Practitioner Form 4 - Verification of Experience - (www.op.nysed.gov/np4.pdf)
  • Nurse Practitioner Form 4NP - Verification of Practice Protocol - (www.op.nysed.gov/np4np.pdf)

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Occupational Therapy

• Occupational Therapy Form 1 - Application for Licensure (www.op.nysed.gov/ot1.pdf)
• Occupational Therapy Form 2 - Certification of Professional Education (www.op.nysed.gov/ot2.pdf)
• Occupational Therapy Form 5 - Application for a Limited Permit (www.op.nysed.gov/ot5.pdf)

Ophthalmic Dispensing

• Ophthalmic Dispensing Form 1 - Application for Licensure (www.op.nysed.gov/od1.pdf)
• Ophthalmic Dispensing Form 2 - Certification of Professional Education in Ophthalmic Dispensing (www.op.nysed.gov/od2.pdf)
• Ophthalmic Dispensing Form 3 - Certification of Ophthalmic Dispensing Licensure in Another Jurisdication (www.op.nysed.gov/od3.pdf)
• Ophthalmic Dispensing Form 4 - Certification of Trainee Experience in Ophthalmic Dispensing And/Or Contact Lens Dispensing (www.op.nysed.gov/od4.pdf)
• Ophthalmic Dispensing Form 5 - Application for Limited Permit (www.op.nysed.gov/od5.pdf)
• Ophthalmic Dispensing Form 5T - Application for a Trainee Permit (www.op.nysed.gov/od5t.pdf)

Optometry

• Optometry Form 1 - Application for Licensure (www.op.nysed.gov/opt1.pdf)
• Optometry Form 2 - Certification of Professional Education (www.op.nysed.gov/opt2.pdf)
• Optometry Form 3 - Certification of Optometry Licensure in Another Jurisdiction (www.op.nysed.gov/opt3.pdf)
• Optometry Form 4 - Report of Professional Practice (www.op.nysed.gov/opt4.pdf)
• Optometry Form 4a - Supporting Affidavit of Professional Practice (www.op.nysed.gov/opt4a.pdf)

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Pharmacy

• Pharmacist

  • Pharmacist Form 1 - Application for Licensure (www.op.nysed.gov/pharm1.pdf)
  • Pharmacist Form 2 - Certification of Professional Education (www.op.nysed.gov/pharm2.pdf)
  • Pharmacist Form 4 - Certification of an Internship in Pharmacy (www.op.nysed.gov/pharm4.pdf)
  • Pharmacist Form 5 - Application for a Limited (Intern) Permit (www.op.nysed.gov/pharm5.pdf)
  • Pharmacist Immunization Certification Form (www.op.nysed.gov/pharmimmuncert.pdf)
  
  

• Pharmacy Establishment

  • Notice of Change of Supervising Pharmacist (www.op.nysed.gov/formph205.pdf)
  • Retail Drug Price List Information

Physical Therapy

• Physical Therapy Form 1 - Application for Licensure (www.op.nysed.gov/pt1.pdf)
• Physical Therapy Form 2 - Certification of Professional Education (www.op.nysed.gov/pt2.pdf)
• Physical Therapy Form 3 - Certification of Physical Therapist or Physical Therapist Assistant Licensure in Another State (www.op.nysed.gov/pt3.pdf)
• Physical Therapy Form 5 - Application for Limited Permit (www.op.nysed.gov/pt5.pdf)

Podiatry

• Podiatry Form 1 - Application for Licensure (www.op.nysed.gov/pod1.pdf)
• Podiatry Form 2 - Certification of Professional Education (www.op.nysed.gov/pod2.pdf)
• Podiatry Form 3 - Certification of Podiatry License in Another Jurisdiction (www.op.nysed.gov/pod3.pdf)
• Podiatry Form 4pgy - Certification of Approved Podiatric Postgraduate Training (www.op.nysed.gov/pod4pgy.pdf)
• Podiatry Form 5a - Application for a Limited Permit for Applicants Seeking Licensure in New York (www.op.nysed.gov/pod5a.pdf)
• Podiatry Form 5b - Application for a Limited Permit for Applicants Not Seeking Licensure in New York (www.op.nysed.gov/pod5b.pdf)
• Podiatry Form 5c - Application for a Limited Residency Permit for Applicants Seeking Licensure in New York (www.op.nysed.gov/pod5c.pdf)
• Podiatry Form 5d - Application for a Limited Residency Permit for Applicants Not Seeking Licensure in New York (www.op.nysed.gov/pod5d.pdf)

Psychology

• Psychology Form 1 - Application for Licensure (www.op.nysed.gov/psych1.pdf)
• Psychology Form 2 - Certification of Professional Education (www.op.nysed.gov/psych2.pdf)
• Psychology Form 3 - Certification of Out of State Licensure and Examination Grades (www.op.nysed.gov/psych3.pdf)
• Psychology Form 4 - Report of Professional Experience (www.op.nysed.gov/psych4.pdf)
• Psychology Form 5A - Application for Limited Permit For Persons Gaining Experience For Licensure (www.op.nysed.gov/psych5a.pdf)
• Psychology Form 5B - Application for Limited Permit For Persons Licensed In Other Jurisdictions (www.op.nysed.gov/psych5b.pdf)

Public Accountancy

• CPA Form 1 - Application for Licensure (www.op.nysed.gov/cpa1.pdf)
• CPA Form 2 - Certification of Professional Education (www.op.nysed.gov/cpa2.pdf)
• CPA Form 3 - Certification of Out-of-State Licensure and Examination Grades (www.op.nysed.gov/cpa3.pdf)
• CPA Form 4 - Applicant Experience Record (www.op.nysed.gov/cpa4.pdf)
• CPA Form 4b - Certification of Employer (www.op.nysed.gov/cpa4b.pdf)
• Instructions for Completing Certification of Employer Form 4b (www.op.nysed.gov/cpa4binst.pdf)

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Respiratory Therapy

• Respiratory Therapy Form 1 - Application for Licensure (www.op.nysed.gov/rt1.pdf)
• Respiratory Therapy Form 2 - Certification of Professional Education (www.op.nysed.gov/rt2.pdf)
• Respiratory Therapy Form 5 - Application for Limited Permit (www.op.nysed.gov/rt5.pdf)

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Social Work

Licensed Master Social Worker

• Licensed Master Social Worker Form 1 - Application for Licensure (www.op.nysed.gov/lmsw1.pdf)
• Licensed Master Social Worker Form 2 - Certification of Professional Education (www.op.nysed.gov/lmsw2.pdf)
• Licensed Master Social Worker Form 3 - Verification of Social Work Licensure in Another Jurisdiction (www.op.nysed.gov/lmsw3.pdf)
• Licensed Master Social Worker Form 5 - Application for a Limited Permit (www.op.nysed.gov/lmsw5.pdf)

Licensed Clinical Social Worker

• Licensed Clinical Social Worker Form 1 - Application for Licensure (www.op.nysed.gov/lcsw1.pdf)
• Licensed Clinical Social Worker Form 2 - Certification of Professional Education (www.op.nysed.gov/lcsw2.pdf)
• Licensed Clinical Social Worker Form 3 - Verification of Social Work Licensure in Another Jurisdiction (www.op.nysed.gov/lcsw3.pdf)
• Licensed Clinical Social Worker Form 4 - Verification of Experience for Licensed Clinical Social Workers (www.op.nysed.gov/lcsw4.pdf)
• Licensed Clinical Social Worker Form 4b - Certification of Experience for Licensed Clinical Social Workers (www.op.nysed.gov/lcsw4b.pdf)
• Licensed Clinical Social Worker Form 4q - Licensed Psychologist Qualified to Supervise Psychotherapy (www.op.nysed.gov/lcsw4q.pdf)
• Licensed Clinical Social Worker Form 5 - Application for a Limited Permit (www.op.nysed.gov/lcsw5.pdf)

Psychotherapy Privilege

• Social Work Psychotherapy Privilege Form 1SWPR - Application for Psychotherapy Privilege of Certified Social Workers (www.op.nysed.gov/swpr1.pdf)
• Social Work Psychotherapy Privilege Form 4SWPR - Certification of Experience (www.op.nysed.gov/swpr4.pdf)
• Social Work Psychotherapy Privilege Form 4Q - Psychologist Qualified in Psychotherapy (www.op.nysed.gov/swpr4q.pdf)

Speech-Language Pathology and Audiology

• Speech-Language Pathology and Audiology Form 1 - Application for Licensure (www.op.nysed.gov/sla1.pdf)
• Speech-Language Pathology and Audiology Form 2 - Certification of Professional Education (www.op.nysed.gov/sla2.pdf)
• Speech-Language Pathology and Audiology Form 4a - Identification of Supervisor and Setting (www.op.nysed.gov/sla4a.pdf)
• Speech-Language Pathology and Audiology Form 4b - Record of Supervised Experience (www.op.nysed.gov/sla4b.pdf)

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Veterinary Medicine

• Veterinarian

  • Veterinary Medicine Form 1 - Application for Licensure (www.op.nysed.gov/vet1.pdf)
  • Veterinary Medicine Form 1LL - Application for a Three-year Limited License (www.op.nysed.gov/vet1ll.pdf)
  • Veterinary Medicine Form 2 - Certification of Professional Education (www.op.nysed.gov/vet2.pdf)
  • Veterinary Medicine Form 2PPE - Certification of Pre-professional Education (www.op.nysed.gov/vet2ppe.pdf)
  • Veterinary Medicine Form 2CT - Certification of Clinical Training (www.op.nysed.gov/vet2ct.pdf)
  • Veterinary Medicine Form 3 - Verification of Out-of-state Licensure, Registration, and/or Examination (www.op.nysed.gov/vet3.pdf)
  • Veterinary Medicine Form 4 - Verification of Professional Practice (www.op.nysed.gov/vet4.pdf)
  • Veterinary Medicine Form 5 - Application for Limited Permit (www.op.nysed.gov/vet5.pdf)
  
  

• Veterinary Technician

  • Veterinary Technology Form 1 - Application for Licensure (www.op.nysed.gov/vt1.pdf)
  • Veterinary Technology Form 1LL - Application for a Three-year Limited License (www.op.nysed.gov/vt1ll.pdf)
  • Veterinary Technology Form 2 - Certification of Professional Education (www.op.nysed.gov/vt2.pdf)
  • Veterinary Technology Form 3 - Verification of Out-of-state Licensure, Registration, and/or Examination (www.op.nysed.gov/vt3.pdf)
  • Veterinary Technology Form 4 - Verification of Professional Practice (www.op.nysed.gov/vt4.pdf)
  • Veterinary Technology Form 5 - Application for Limited Permit (www.op.nysed.gov/vt5.pdf)

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Non-Profession Specific Forms

• Address/Name Change Form (www.op.nysed.gov/anchange.pdf)
• Application for State Board Membership (www.op.nysed.gov/bdnom.pdf)
• Attestation of Infection Control Training (www.op.nysed.gov/form1ic.pdf)
• Child Support Obligation Form (www.op.nysed.gov/form1cs.pdf)
• Citizenship and Immigration Status Form (www.op.nysed.gov/form1is.pdf)
• Gender and Ethnicity Data Form (www.op.nysed.gov/form1d.pdf)
• Mandated Training Related to Child Abuse - Certificate of Exemption Form (www.op.nysed.gov/form1ce.pdf)
• Mandatory Continuing Education Questionnaire for Delayed Registration (www.op.nysed.gov/mcequest.pdf)
• Professional Assistance Program Application (non-PDF) (www.op.nysed.gov/papapp.htm)
• Professional Discipline Complaint Form (www.op.nysed.gov/opd-complaint.pdf)
• Request for Reasonable Testing Accommodations (www.op.nysed.gov/pls1ra.pdf)
• Request for Written Confirmation of NYS Licensure (www.op.nysed.gov/confirmoflic.pdf)
• Student Loan Disclosure Form (www.op.nysed.gov/form1sl.pdf)

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