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Commonly Requested Forms...
Forms For Online Applications Process

SUPERVISION STATEMENTS

License/Application Type

Supervision Statement Type

LPED – TEMPORARY

EXAM PENDING / EXAM NOT COMPLETED

LPED – TEMPORARY

EXAM COMPLETED

LPED – UPGRADE FROM TEMP OR ISSUE AS FULL

SUPERVISION COMPLETED

LO / LP / LPO - TEMPORARY

SUPERVISION PLAN

LO-LP-LPO – UPGRADE  OR ISSUE AS FULL

SUPERVISION COMPLETE

MISCELLANEOUS FORMS

SUPPLEMENTAL/COMPLIANCE AFFIDAVIT

 2018 OPPCE REMEDIATION WORKSHEET

 

 

Application, Renewal, and Miscellaneous Fees:

The following fee schedule will be implemented for all transactions and services pursuant to an action taken by the Board at its September 26, 2017 meeting.  In the case of a discrepancy between information on a form and information on this schedule, please refer to the information on this schedule.

Initial License Application – All Types – Full          

$100

Initial License Application – All Types – TEMP          

$100

Annual License Renewal – All Types – Full              

$200

One-time License Renewal – All Types – TEMP    

$200

Late Fee – License Renewal                                   

$100

Late Fee – OPPCE                                                             

$100

License Upgrade – TEMP>Full                                  

$50

License Consolidate – LO or LP > LPO                

$50

New OPPCE Activity Review                            

$ 50

Certified license verification  OR Replace wall certificate                     

$ 25

Fine, per violation                                              

$250

NEW SYSTEM FEE NOW ASSESSED FOR APPLICATION AND RENEWAL PROCESSING:  eLicense System Transaction Fee: An eLicense System Transaction Fee is now being charged to all license transactions that result in the issuance, renewal, or reinstatement of a license or registration served by the eLicense Ohio portal. The revenue generated from this eLicense System Transaction Fee is paid to the State of Ohio and supports the operational and maintenance costs of the eLicense Ohio portal. Licensing boards do not receive revenue from this eLicense System Transaction Fee. This fee is nonrefundable.


The disciplines of Orthotics, Prosthetics and Pedorthics are regulated fields in the state of Ohio. Please be sure to download and complete all applicable forms listed under the profession for which you are applying.

Do you hold a license issued by another state that licenses in O&P?  Before completing your application, please review Ohio's Limited Reciprocity provisions here:    Limited Reciprocity Provisions

Orthotics and/or Prosthetics:

Criminal Records Check Instructions

Active Military & Veterans Questionnaire - 2014 Revision

Pedorthics:

Criminal Records Check Instructions

Active Military & Veterans Questionnaire - 2014 Revision

Pedorthics Pre-certification Providers

License Reinstatement (For licenses lapsed more than two years) -- All license application,  renewal and reinstatement processes are now handled online through the state of Ohio e-License portal.  If you hold or have held a license issued under ORC Chapter 4779 (Orthotics, Prosthetics and Pedorthics), you likely have data in the system.  If you don't have an active license and are not registered in the system, send an email to the Board requesting registration information.

     

Active Military & Veterans Benefits:

In an effort to promote opportunities for and inclusion of active military, veterans, and their spouses in the licensed occupational fields offered in Ohio, and in compliance with Am. Sub. House Bill 98, the State Board of Orthotics, Prosthetics and Pedorthics would like to ask you a few questions about your or your spouse's current or prior military service.

Completion of this document at the time of initial application may entitle you to certain licensure benefits, including but not limited to expedited processing of your application.

Active Military & Veterans Questionnaire - 2014 Revision

Complaint Form:

Complaint Form (PDF Version, for FAX or Postal Submission)

OPP Continuing Education Forms:

2018 OPPCE Remediation Worksheet

Application for Approval of OPPCE Units for a Continuing Education Course not already approved by ABC or BOC.

Application for Approval of OPPCE Credits for Teaching activities that comply with statutory requirements (see form for details)

Continuing Education Course Provider's Application to have a CE course you wish to offer approved for OPPCE credit

The State Board of Orthotics, Prosthetics & Pedorthics
Mark B. Levy, Director
77 S. High St., 18th Floor  •  Columbus, OH 43215-6108
Tel: (614) 466-1157   •  Fax: (614) 387-7347   •  Email Us