Ohio.gov  |   State Agencies   |   Online Services
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 AFFIDAVIT

 OPPCE ACCRUAL REMEDIATION WORKSHEET

 

 

Application, Renewal, and Miscellaneous Fees:

The following fees will be required for all transactions and services occurring on or after September 1, 2015.  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          

$150

Initial License Application – All Types – TEMP          

$150

Annual License Renewal – All Types – Full              

$400

One-time License Renewal – All Types – TEMP    

$400

Late Fee – License Renewal                                   

$200

Late Fee – OPPCE                                                             

$200

License Upgrade – TEMP>Full                                  

$100

License Consolidate – LO or LP > LPO                

$100

License Issuance                                            

$100

New OPPCE Activity Review                            

$ 50

Certified license verification  OR Replace wall certificate                     

$ 25

Fine, per violation                                              

$250

Miscellaneous Fees Mail-in Form -- please use this form only when requested by board staff.  Payments should be made by online process whenever possible. 







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 renewal expiry 01.31.2016:

Blank Renewal Mail-in Form  (license expiry 01.31.2016)

OPPCE Statement of Compliance (license subcategory "3" license first issued prior to 2015)



License Reinstatement:

License Reinstatement Application 2014 Revision (For licenses lapsed more than two years)

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:

OPPCE Report Form Renewal Year 2016 (expiry 01.31.2016) [for use only to respond to post-renewal audit request]

OPPCE Accrual 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