Perfusionist

Education Law section 8609(9) provides an exemption from the clinical laboratory technology licensure requirements for "the performance of, use of, and analysis of the results from point of care tests and instruments used to monitor coagulation, blood gas and blood chemistry and hemoglobin and hematocrit pursuant to an order and under the direction and supervision of a licensed physician by individuals employed on a salaried basis by a hospital and issued a permit by the Department.”

More information on section 8609(9) can be found in Article 165 of New York's Education Law.

Applying for a Permit | Fees | Application Forms

Applying for a Permit

A permit authorizes practice as a perfusionist under the supervision of a physician licensed and currently registered in New York State at a hospital where you are employed on a salaried basis.

To apply for a permit to practice as a perfusionist in New York State, you must submit an Application for Permit (Form 5) along with the $50 Permit fee to the Office of the Professions. You must also have a Verification of Employment by Hospital (Form 5A) submitted by the Hospital where you are employed on a salaried basis.

A permit holder is subject to the full disciplinary and regulatory authority of the Board of Regents, pursuant to Title VIII of the Education Law, as if the permit were a professional license under Article 165 of the Education Law.

The permit is valid for two years. However, because Chapter 479 will expire and be deemed repealed on July 1, 2014, the permit will expire on that date unless the effective date of the law is extended. Individuals licensed in other professions who are already permitted to engage in these practices within the scope of practice of their professions may continue to do so without the need for this permit.


Fees

The Permit fee for Perfusionists is $50.

Fees are subject to change. The fee due is the one in law when your application is received (unless fees are increased retroactively). You will be billed for the difference if fees have been increased.

  • Do not send cash.
  • Make your personal check or money order payable to the New York State Education Department. Your cancelled check is your receipt.
  • Mail your application and fee to:

    NYS Education Department
    Office of the Professions
    PO Box 22063
    Albany, NY 12201

NOTE: Payment submitted from outside the United States should be made by check or draft on a United States bank and in United States currency; payments submitted in any other form will not be accepted and will be returned.


Forms

Form 5 - Application for Permit (PDF 23 KB)

All applicants for a perfusionist permit must complete this form and submit it with the $50 permit fee directly to the Office of the Professions at the address at the end of the form. Make checks payable to the New York State Education Department.

NOTE: Your cancelled check is your receipt.

You must answer all questions and provide all information requested unless otherwise indicated. Failure to complete all required parts of the application will delay its review.

You must also have a Verification of Employment by Hospital (Form 5A) submitted by the Hospital where you are employed on a salaried basis. Your permit cannot be issued until the Department receives and approves all required documentation.

If you change employment after a permit is issued, you must obtain a new permit, and with the prospective employer, complete and submit a new Application for Permit (Form 5), $50 permit fee. A new supporting Verification of Employment by Hospital (Form 5A) must also be submitted. The original permit must be signed/dated on the back and returned to the Department.

Form 5A - Verification of Employment by Hospital (PDF 13 KB)

Section I: Complete this section, be sure to sign and date the affirmation before forwarding both pages of this form to the hospital were you are employed as a perfusionist on a salaried basis.

Section II: Ask the hospital that they complete Section II before submitting all pages of this form to the Office of the Professions at the address at the end of the form. This form will not be accepted if submitted by the applicant.

Last Updated: December 19, 2012