Application Forms for Optometry

All applicants for licensure must initially submit Form 1 along with the appropriate fee. You must answer all questions and provide all information requested unless otherwise indicated. Failure to accurately complete all required parts of the application will delay its review. Additional forms below are required based on the licensure requirements of the profession. Do not use Form 1 to renew your existing license.

Continuing Your Application
If you have started an application within the past 30 days, and have not yet completed it, you can use this link to continue your application. You will need your Application ID, Social Security Number, and Date of Birth.

Upload Additional Documentation
If you have already completed an application, but you have additional documents or files to include in your previous submission, use this link to upload additional documentation. You will need your Application ID and Date of Birth.

Use this form to apply to use pharmecuetical agents while practicing optometry. In order to obtain these certifications, you must have applied for New York State licensure as an Optometrist. 

Continuing Your Application
If you have started an application within the past 30 days, and have not yet completed it, you can use this link to continue your application. You will need your Application ID, Social Security Number, and Date of Birth.

Upload Additional Documentation
If you have already completed an application, but you have additional documents or files to include in your previous submission, use this link to upload additional documentation. You will need your Application ID and Date of Birth.

 

This form must be completed and submitted by the educational institution. The Office of the Professions will not accept this form if it is submitted by the applicant.

• Section I: Complete this section of the form before sending it to your school. Be sure to sign and date item 9.
• Section II: The Registrar must complete this section and return the form directly to the Office of the Professions at the mailing address on the form.

Electronic Education Documentation

The Office of the Professions (OP) will accept official electronic transcripts and forms from educational institutions (i.e. colleges/universities) or designated third-party* transcript entities located in the United States, Canada, Brazil and the Philippines provided that:

• The transcript is the certified true and official academic record and the document does NOT have an expiration date**.
• OP can independently verify that the documentation is received directly from the educational institution’s registrar or officially designated third-party.
• If a third-party transcript provider is involved, it is clear that the educational institution has designated the third party as the official sole provider of its transcripts.
• The applicant had no opportunity to directly access or alter the transcript before it is sent or transmitted.
• Any educational institution education documentation submissions should be made electronically to DPLSEduc@nysed.gov***.

*OP will only accept third-party submissions after we have determined that the arrangement between the educational institution and the third party is consistent with our security and verification standards.

**Transcript documents with expiration dates cannot be accepted. Expirations on links to the document are acceptable.

***Do NOT use this email to submit a question, as we will be unable to provide a response. Submit a Contact Us Form for questions regarding specific applications or to check the status of a licensure application.

Use this form only if you are or have been licensed/certified in another jurisdiction.
 

• Section I: Complete this section of the form before sending it to the licensing authority of each jurisdiction in which you are or have been licensed/certified. Be sure to sign and date item 7 and include any fee required by the licensing authority.
• Section II: The licensing authority must complete this section, sign, date and return the form directly to the Office of the Professions at the address at the end of the form.

Note: A Form 3 is not required for licenses/certificates issued by the New York State Education Department. Also, If the certification/verification documentation provided by a U.S. jurisdictions contains the same information requested in the Form 3, completion of a Form 3 for that jurisdiction is not necessary. For certification/verification documentation that does not contain the same information, a Form 3 will need to be completed for that jurisdiction.

ONLY use this form if you are applying for licensure in New York State by endorsement, have completed the NBEO Examination Parts I and II, and HAVE NOT COMPLETED either the NBEO Part III or NERCOATS examination.

Complete this form and submit it to the Office of the Professions at the address at the end of the form. Be sure to sign and date item 5.

ONLY use this form if you are applying for licensure in New York State by endorsement, have completed the NBEO Examination Parts I and II, and HAVE NOT COMPLETED either the NBEO Part III or NERCOATS examination.

• Complete Section I. Be sure to sign and date item 8.
• Send the entire form to a licensed optometrist or ophthalmologist who will endorse your professional practice and ask that they complete Section II and submit the completed 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.

Important Note: You must present evidence of at least 5 years of professional practice of optometry following initial licensure and within 10 years of applying for licensure endorsed by other licensed optometrists and/or ophthalmologists using Form 4A.

Electronic Verification of Experience

The Office of the Professions (OP) will accept experience forms directly from supervisors provided that:

• OP can independently verify that the documentation is received directly from the supervisor
• The applicant had no opportunity to directly alter the experience form before it is sent or transmitted.
• Any experience documentation submissions should be made electronically to DPLSExperience@nysed.gov*.

*Do NOT use this email to submit a question, as we will be unable to provide a response. Submit a Contact Us Form for questions regarding specific applications or to check the status of a licensure application.

This form is not for all applicants. Use this form only if you are applying for an exemption to the requirement to complete training or coursework in the identification of child abuse and maltreatment because the nature of your practice excludes contact with persons under the age of 18 and persons 18 or older with a handicapping condition who reside in a residential care school or facility.