Form Od-01 1016r - Application For Exam & License - Optometrist Page 3
Download a blank fillable Form Od-01 1016r - Application For Exam & License - Optometrist in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form Od-01 1016r - Application For Exam & License - Optometrist with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3
4
5
6BIENNIAL RENEWAL
Licensees shall renew licenses on or before December 31 of each odd-numbered year. There is no grace period for
AND CONTINUING
renewals. Practicing optometry without a current license shall constitute unlicensed activity.
EDUCATION
Licensees who are not therapeutically certified shall obtain 32 hours of approved continuing education during the
biennium.
A person who is initially licensed in the first year of the biennium shall be required to submit certification of having
earned 16 hours of continuing education for the biennium and a person who obtains licensure in the second year of
the biennium need not obtain any continuing education hours for the first renewal of the license.
Licensees who are therapeutically certified shall obtain 36 hours of Board approved continuing education courses in
the diagnosis, treatment, and management of ocular and systemic diseases, regardless of initial date of licensure.
The one hundred hour course in the treatment and management of ocular disease shall satisfy the 36 hour
continuing education requirement provided that the course was taken within the two years prior to the date the
application for license renewal was received by the Board, and credits for the course were not used for a previous
license renewal.
To review the complete continuing education requirements for relicensure, please see Hawaii Administrative Rules
§§16-92-38 through 16-92-42.
LAWS & RULES
To obtain a copy of the Board's laws, Chapter 459, Hawaii Revised Statutes and rules, Chapter 92, Hawaii
PUBLICATION
Administrative Rules, send a written request to the address below. You are responsible for knowing and
understanding the laws and rules and any amendments made to them throughout your career. Chapter 436B,
Hawaii Revised Statutes, the Professional and Vocational Licensing Act should be read in conjunction with the above
laws and rules.
The laws and rules are also posted on our website at: cca.hawaii.gov/pvl. Look under "Optometry".
Mail to:
Deliver to office location at:
BOARD'S
ADDRESS
Board of Examiners in Optometry
335 Merchant Street, Room 301
OR
DCCA, PVL Licensing Branch
Honolulu, HI 96813
P. O. Box 3469
Honolulu, HI 96801
Phone: (808) 586-3000
LICENSEE ADDRESS
Pursuant to Section 16-92-3, HAR, you are required to file your business address with the Board and notify the Board
in writing of any and all changes within 30 days of the change.
Instructions for "YES" Answers to Questions (8) through (10) of the Application for Exam & License (OD-01)
A.
The following documentation must be submitted with the license application. Applications for license will not be considered without this
material.
1.
Questions 8 and 9 refer to complaints, charges of unlicensed activity, or pending disciplinary actions for any profession, occupation, or
license. If your answer is "YES" to one or more of these questions, read paragraph "B" (on page 4), AND you must submit the
following:
i.
A detailed statement signed by you explaining the circumstances; and
ii.
Copies of any documents from the agency, including final orders, petitions, complaints, findings of fact and conclusions of law,
and any other relevant documents;
If your application indicates a criminal conviction, read paragraph "B" (on page 4), AND you must submit the following:
2.
i.
A detailed statement signed by you explaining the circumstances leading to the conviction and detailing all activities since the
conviction, including employment and business involvements. Include job title, period of employment, employer's name,
description of duties, training attended, and educational courses attended.
ii.
A copy of the court order, verdict, and terms of sentence; and
(CONTINUED ON PAGE 4)
-3-
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business