Form Doh 662-097 - Optometrist License Application Packet Page 22

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45. After receiving from a patient, a written request for a copy of the patient’s record, an
optometrist:
A. must provide the requested information within thirty days
B. may withhold the information if the patient has an outstanding balance for services
provided by the optometrist
C. must provide a copy to the patient no later than fifteen working days after receiving the
request
D. is not required to provide a copy of the patient’s record directly to the patient
46.
RCW 69.41.010(1)
Legend Drugs-Prescription Drugs, requires all written prescriptions must
be:
A. written in 12 point font
B. either printed on tamper proof paper or electronically generated
C. written on buff colored paper
D. written in duplicate
47. When a patient has been harmed, mandatory reports are submitted to:
A. The disciplinary authority
B. The Office of the Attorney General
C. The Department of Health
D. The national practitioner data bank
48. Any license holder must self report:
A. any conviction, determination, or finding that he or she has committed unprofessional
conduct.
B. information that he or she is unable to practice with reasonable skill and safety due to a
mental or physical condition.
C. any disqualification from participation in the federal Medicare or Medicaid program.
D. all of the above.
49. The mandatory reports must be submitted within_______ days after the reporting person has
actual knowledge of the information that must be reported.
A. 60 days
B. 30 days
C. 14 days
D. 10 days
50. A license holder must report another license holder when he or she:
A. Has actual knowledge of any conviction, determination, or finding that another license
holder committed unprofessional conduct or is not able to practice with reasonable skill
and safety.
B. is providing health care to the other license holder and the other license holder does not
pose a clear and present danger to patients or clients.
C. is part of a federally funded substance abuse program or impaired practitioner or voluntary
substance abuse program and the other license holder is participating in treatment and
does not pose a clear and present danger to patients or clients.
D. is a member of a professional review organization.
DOH 662-078 April 2017
Page 8 of 8

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