Introduction

The Arizona Board of Osteopathic Examiners has developed an online portal for the processing of initial osteopathic applications to reduce processing time and provide applicants the ability to track the status of their applications.

The landing page can be found on the Board’s webpage under Initial Licensing. Once an account has been created, applicants can track the status of their application by providing their tracking number and password on the portal page.

Process Checklist

You can use the below checklist to track your progress throughout the application portal.

Step	Action	Done
1	Gather required documents (i.e., Medical School information, Post-Graduate programs, examinations, citizenship paperwork, passwords, IDs, credit card, employment history, CV / resume, address information, information about other states' licenses, etc.)	☐
2	Create an Account and write down tracking number and password for future reference.	☐
3	Complete personal information and background information.	☐
4	Entered Practice, home, and mailing addresses and designated a delegated agent to receive information about my application (if desired).	☐
5	Entered Professional History information.	☐
6	Entered Medical School information and contacted the school to have a copy of my transcripts sent to the Board.	☐
7	Entered Post Graduate Training program information and contacted the program(s) to have a copy of the Board’s Form 2 sent to the Board.	☐
8	Entered examination information and contacted the testing organization to have a copy of my transcripts sent to the Board.	☐
9	Entered my Specialty Information and contacted the AOA or FCVS to have any documents sent to the Board.	☐
10	Answered my professional conduct questions truthfully and contacted any organizations to have any documents sent to the Board.	☐
11	Entered my Medical Employment History.	☐
12	Completed all the training case studies and general questions.	☐
13	Completed the Arizona Statement of Citizenship and sent my acceptable documents to the Board.	☐
14	Reviewed my confirmation page, updated any information as needed, attested to my application, and printed a copy of the document for reference.	☐
15	Made the required payment and printed a receipt for my records.	☐
16	Register with Arizona’s Controlled Substance Prescription Monitoring Program for the prescribing of controlled substances. Use the following Link: https://arizona.pmpaware.net/identities/new	☐

Creating an Account

On the Create a New DO Applicant Page you will need to enter the following information:

Tips:

Please be aware that capitalization and spelling matter during this process. How you enter the information is how it will appear on your online profile. The system does not automatically update these issues, and to change certain items will require our staff to update them for you, which can delay the processing of your application. We strongly recommend reviewing your provided answers and their formatting, this will ensure a smooth application process.

If you have received a Post-Graduate Permit from the Arizona Osteopathic Board, you will need to enter it on the Permit/Registration Number line. Permit numbers begin with the Letter R. You will have received this from your program.

Passwords should have at least a Capital Letter, a number, a symbol, and a mix of remaining characters for a total of 8. Passwords must not be shared with anyone. All passwords are to be treated as sensitive and confidential information.

Your Social Security Number, Date of Birth, Place of Birth, and Email Address are Confidential Information and not for Public Disclosure.

Once you have entered all your information and reviewed the formatting, select the Register button found on the bottom right of your screen.

New Applicant Registration Confirmation Page

After you select the Register button, the system will process your information and create your tracking number. The page will progress to a confirmation page for you to save this tracking information for future reference.

Select the next button to proceed to the application.

Tips:

You will need to keep your tracking number to review the status of your application. After you submit your full application, you can use the portal page to review the status of your application and what documents you need to contact the primary source and have sent to the Board.

We have even provided a print button so that you may print your tracking number for easy reference.

Personal Information - Page 1

On the first page of the application, you will need to provide your information to verify your identity.

After entering your information, select the next button at the bottom right of your screen.

Important Information:

Are you an active duty military service member’s spouse? Please gather documentation of your spouse’s service (Active Duty Posting information, Service Papers, Current Military Assignment documents, etc.) and marriage documentation and contact the Board office for additional information related to your potential application fees as required by A.R.S.§41-1081.01.

Are you an honorably discharged veteran within the last two years? Please gather you DD Form 214 (Report of Separation) and contact the Board office for additional information related to your potential application fees as required by A.R.S.§41-1081.01.

Tips:

If your location of birth is outside the United States or Canada, please select “FC” in the dropdown list for your State of Birth.

We have provided fields for your NPI and DEA numbers. If you have not been provided one or both of those numbers, you will not need to provide them in the provided fields.

Existing Alias Names - Page 2

On this page of the application, you will need to provide any existing aliases.

After entering your information or if you have no aliases, you can select the next button at the bottom right of your screen to progress forward with the application.

Tips:

If you have multiple aliases, you can use the Add another Alias Name button to add as many aliases as needed.

Practice Address - Page 3

This is the practice/principle place of business. The address and phone number will appear in the Medical Directory and on the Board’s website. Every Physician must have an address available to the public. If only one address is provided, even if it is your home address, it will be available to the public.

Select the Edit Practice Address Link on the right-hand side of the page to enter your Practice Address Information.

Then enter your Practice Address information.

After entering your information, or if you have no practice address, you can select the next button at the bottom right of your screen to progress forward with the application.

Tips:

Please be aware that capitalization and spelling matter during this process. How you enter the information is how it will appear on your online profile and how documents will be mailed to you.

If you need to pause your session, use the Save and Logout button at the bottom of your screen. You will need your tracking number and password to log in again to resume your session.

You can update your addresses any time after your application has been submitted. It is always best to keep your addresses current with the Board, so that staff can contact you about your application without delay.

Home Address - Page 4

You are required to provide a home address and telephone number. They will not be released to the public unless you fail to provide a Practice Address. If only one address is provided, even if it is your home address, it will be available to the public.

Select the Edit Home Address Link on the right-hand side of the page to enter your Home Address Information.

Then enter your Home Address information.

After entering and then reviewing your information, you can select the next button at the bottom right of your screen to progress forward with the application.

Tips:

Please be aware that capitalization and spelling matter during this process. How you enter the information is how it will appear on your online profile and how documents will be mailed to you.

If you need to pause your session, use the Save and Logout button at the bottom of your screen. You will need your tracking number and password to log in again to resume your session.

Mailing Address - Page 5

If no address is provided, all Board correspondence will be sent to the Practice Address. On the Mailing address page, you can also provide the contact information for someone as a designated agent to receive status updates on your application.

Select the Edit Mailing Address Link on the right-hand side of the page to enter your Mailing Address Information.

Then enter your Mailing Address information. Your email address will not be released to the public. On this page, you can also provide the contact information for someone as a designated agent to receive status updates on your application. This would be a spouse or coordinator. Please be advised that any information in your application can then be shared with the designated individual. If you choose not to select a designated agent, Board staff will only provide updates or discuss your application with the applicant.

After entering your information, you can select the submit button at the bottom right of your screen to save the information.

After reviewing your information, you can select the next button at the bottom right of your screen to progress forward with the application.

Tips:

If you have entered a practice address or home address, You can use the buttons at the top left of your screen to copy your address information into the current page.

Please be aware that capitalization and spelling matter during this process. How you enter the information is how it will appear on your online profile and how documents will be mailed to you.

Use an email address that you check regularly. The Board will be sending notices and updates on your application to this address. By using an email address that you regularly view, Board staff can provide timely and accurate communication about your process or get in contact with you if there are any issues with your application. The Board does not sell or provide your email address to anyone.

If you need to pause your session, use the Save and Logout button at the bottom of your screen. You will need your tracking number and password to log in again to resume your session.

Other State Licenses - Page 6

On this page, you will need to provide all states or jurisdictions in which you have applied for or have been granted a license or registration to practice medicine, including license number, date issued, and current status of the license.

To Start, click the Add another State License button. If a license is pending or was not issued, please indicate. If none, please check “Not Applicable.”

After entering your information, you can select the save button at the bottom right of your screen to save the information.

You will need to have licensing verifications sent from every state in which you hold, or have held a license. Please contact each state and have them send a licensing verification to the Board Address. The Board will accept emailed verifications sent to: Licensing@azdo.gov.

After reviewing your information, you can select the next button at the bottom right of your screen to progress forward with the application.

Tips:

If you have multiple licenses, you can use the Add another State License button to add as many licenses as needed.

If you need to pause your session, use the Save and Logout button at the bottom of your screen. You will need your tracking number and password to log in again to resume your session.

Medical School - Page 7

On this page, add your Medical School information using our search feature. Search for your school using the School Name, Country, or City.

Once you enter information into one of the three search fields, hit search.

Then select your school from the list by hitting the choose button.

It will take you to a new page to confirm the school information on the date of your degree.

Once you have entered your degree date, hit the save button to return to the school page.

You will need to have a copy of your medical school transcripts sent from your medical school. Please contact your school and have them send a copy of your transcripts to the Board Address. The Board will accept emailed transcripts sent to: Licensing@azdo.gov.

After reviewing your information, you can select the next button at the bottom right of your screen to progress forward with the application.

Tips:

Please enter the first day of the month if you are not sure of the exact degree date.

** If you do not find the medical school you attended, click the "Missing School" button to add the school to your profile.

If you graduated from a medical school located outside the United States of America or Canada, you will need your ECFMG number and to verify that you are applying via the Fifth Pathway and that you can read, write, speak, understand, and be understood in the English language.

If you need to pause your session, use the Save and Logout button at the bottom of your screen. You will need your tracking number and password to log in again to resume your session.

Post-Graduate Training Program - Page 8

On this page, add your Post-Graduate Training Program information. To Start, click the Add Program button.

It will take you to a new page to enter the program information. Then enter your program information in the provided fields.

If you have multiple programs, hit the Save and Add Another Program button and if you only need to enter one program, hit the Save button. It will return you to the Post-Graduate Programs Screen.

You will need to have a verification of your post-graduate training sent from your program. Please contact your program and have them send a completed Form 2 to the Board Address. The Board will accept emailed Form 2 sent to: Licensing@azdo.gov.

After reviewing your information, you can select the next button at the bottom right of your screen to progress forward with the application.

Tips:

If your program is closed, you will need to contact the Federation of State Medical Boards or the American Osteopathic Association to determine if verification of your program can be provided to the Board.

Please enter the first day of the month if you are not sure of the exact Start and End date.

Please be aware that capitalization and spelling matter during this process. How you enter the information is how it will appear on your online profile.

If you need to make any changes to your program, hit the update button to the right of the program.

If you need to pause your session, use the Save and Logout button at the bottom of your screen. You will need your tracking number and password to log in again to resume your session.

Licensing Examinations - Page 9

On this page, add your Licensing Examination information. Use a checkmark to indicate that you have taken that specific exam and the date taken. For the COMLEX or other multi-part exams, indicate the final date, the exam was taken.

After selecting the licensing exams and entering the information, select Update Exams to save the information.

You will need to have a verification of your examination results sent from the testing organization. Please contact the organization and have them send a copy of the examination results to the Board Address. The Board will accept emailed results sent to: Licensing@azdo.gov.

After reviewing your information, you can select the next button at the bottom right of your screen to progress forward with the application.

Tips:

Please enter the first day of the month if you are not sure of the exact date.

If you need to pause your session, use the Save and Logout button at the bottom of your screen. You will need your tracking number and password to log in again to resume your session.

Specialities - Page 10

On this page, add your specialty information. To Start, click the Add Specialty button.

If you have multiple specialties, hit the Save and Add Another Specialty button and if you only need to enter one Specialty, hit the Save button. It will return you to the Specialities Screen.

Additionally, if you are providing verification of your information via the FCVS (Federation Credentials Verification Services), check the box on this page. The Arizona Board of Osteopathic Examiners accepts Federation Credentials Verification Services (FCVS) documents that are received by the Board directly from the Federation of State Medical Boards (FSMB) as verification. Contact the Federation at http://fsmb.org if you need more information regarding this service.

Professional Conduct Questionnaire- Page 11

On this page, answer the questions about your professional conduct. Please note that you should error on the side of providing more information than less. Failing to provide information to the Board will delay your application, will require you to appear before the Board and could result in the denial of your application. Licensure denials are disciplinary actions and reportable to the National Practitioner Databank.

After answering all questions and providing a summary of any yes answers in the provided text boxes, hit the next button.

Please note that if you have answered yes to any of the questions on this page, you will need to have copies of those records sent to the Board. Delays in sending that information will result in a delay in the processing of your application.

Tips:

If you question if you need to answer yes to any of the questions, then we encourage you to do so. Staff is able to better process your application with more information, and a false answer can lead to delays and possible denial of your application for licensure.

You will need to have all documents sent from the appropriate organizations. Please contact the organization and have them send a copy of the documents to the Board Address. The Board will accept emailed documents sent to: Licensing@azdo.gov

Confidential Questionnaire- Page 11

On this page, these questions are confidential. Please note that you should error on the side of providing more information than less.

After answering all questions and providing a summary of any yes answers in the provided text boxes, hit the next button.

Tips:

If you have any questions or if you have an issue that you would like to speak with staff about regarding these confidential questions, please contact Board staff at 602-771-2525 or Licensing@azdo.gov.

Employment History- Page 12

Please list all medical employment to include all medical professional activities for the 7 years preceding the date of application. List all physician placement groups related to employment, emergency medical groups, radiology groups, locum tenens placement agencies, etc.

You do not need to list any Post Graduate Training as medical employment. To Start, click the Add Employer button.

If you have had multiple Employers in the last 7 years, hit the Save and Add Another Employer button and if you only need to enter one Employer, hit the Save button. It will return you to the Medical Employment Screen.

If you have not been employed during the last seven years, please mark the check box. If you are currently in your Post Graduate Traning, please mark the check box.

Tips:

Please enter the first day of the month if you are not sure of the exact date.

If you need to pause your session, use the Save and Logout button at the bottom of your screen. You will need your tracking number and password to log in again to resume your session.

Training Unit Case Studies- Page 13

Please review these questions regarding the Medical Practice Act. They are applicable to your practice and licensure in Arizona. You are provided a scenario and then a multiple choice answer as a response.

Once you have reviewed the scenarios, click the next button at the bottom of the page.

Training Unit General Questions- Page 14

Please review these questions regarding the Medical Practice Act. They are applicable to your practice and licensure in Arizona. You are provided a true or False question and then the answer as a response.

After you have reviewed all the questions, please indicate your attestation of compliance with the training unit by marking the provided check box and selecting next.

Tips:

Attestation is required to proceed forward with the application.

Arizona Statement of Citizenship- Page 15

Please review the question and select options from the drop-down menus.

After you have reviewed all the questions, please indicate your attestation of compliance and truthfulness of the application process by marking the provided check box and selecting next.

Tips:

You will need to have copies of your documents for proof of citizenship or legal presence with your application. A list of acceptable documents can be found on the Board’s website here: List of Acceptable Documents for Citizenship. Please send a copy of the documents to the Board Address. The Board will accept emailed documents sent to: Licensing@azdo.gov

Confirmation - Page 16

This is the final page of the application before payment. Please review all the information and ensure that it is true and correct. As a reminder, please be aware that capitalization and spelling matter during this process. How you enter the information is how it will appear on your online profile. If you need to update or make changes to a particular section, simply click on the blue link to return to that page in the application.

At the bottom of the page, please read the Declaration & Attestation. If you agree, mark the check box and type your name in the provided space.

We have provided a print option so that you can have a copy of your submitted application. We encourage you to print this confirmation page as a reference for your application.

After you have reviewed all the information and completed your attestation. Click next to proceed to the payment page.

Tips:

After pressing the Next button, please be patient, as it may take a few moments to process your data and send you to the payment page.

Payment - Page 17

This is the final page of the application.

Important Information:

Are you an honorably discharged veteran within the last two years? Please gather your DD Form 214 (Report of Separation) and contact the Board office for additional information related to your potential application fees as required by A.R.S.§41-1081.01.

We have provided a print option so that you can have a copy of the payment invoice if you need to be reimbursed by a provider or employer. We encourage you to print this page as needed.

When you are ready, click the Pay Now Button. Enter the cardholder’s information on the subsequent pages.

Payment Confirmation - Page 18

Congratulations! You have successfully completed your application. Board staff will begin the process of verifying your provided information. A copy of the transaction with basic application information will be sent to the email provided on the payment page. You may also print this page for your records. You will be contacted by Board staff.

Applicants can track the status of their application by providing their tracking number and password on the portal page.

CSPMP Registration

If you plan on issuing prescriptions in Arizona, you will need to register with the Arizona Controlled Substance Prescription Monitoring Program (AZ CSPMP). Use the following link to create your account as you are required to check the CSPMP before providing certain types of prescriptions, and failure to obtain an account or check the CSPMP as required can result in disciplinary action on your license: https://arizona.pmpaware.net/identities/new

The Arizona Board of Pharmacy has a link for the registration process should you need assistance.

Arizona Board of Osteopathic Examiners | Process Guide for the Initial Application

Table of contents

Introduction

Process Checklist

Creating an Account

New Applicant Registration Confirmation Page

Personal Information - Page 1

Existing Alias Names - Page 2

Practice Address - Page 3

Home Address - Page 4

Mailing Address - Page 5

Other State Licenses - Page 6

Medical School - Page 7

Post-Graduate Training Program - Page 8

Licensing Examinations - Page 9

Specialities - Page 10

Professional Conduct Questionnaire- Page 11

Confidential Questionnaire- Page 11

Employment History- Page 12

Training Unit Case Studies- Page 13

Training Unit General Questions- Page 14

Arizona Statement of Citizenship- Page 15

Confirmation - Page 16

Payment - Page 17

Payment Confirmation - Page 18

CSPMP Registration

The Arizona Board of Pharmacy has a link for the registration process should you need assistance.