DHP Home > Boards > Optometry > Practitioner Resources > Forms

Forms and Applications

Application Forms

Please use our Application Wizard for guidance on how to apply for initial licensure as an Optometrist.

Application for a license to practice as a TPA-Certified Optometrist are now accepted online. Click here to begin the online application process.

• Instructions to Apply for TPA-Certified Optometrist license
• Application to Reinstate a Virginia TPA-Certified Optometrist License
• Application to Reinstate after Discipline a Virginia TPA-Certified Optometrist License
• Application to Reactive a Virginia Optometrist License

Other Forms

• Request for Verification of Out-of-State License
• Employment Verification
• Request for Verification of a VA License Form
  A Virginia licensee seeking to obtain a verification of his/her license, certification, or registration at no cost may do so by directing a board, employer, insurance provider or other interested parties to License Lookup. This content resource meets the accreditation standards for primary source verification from the top seven-accreditation organizations for healthcare professionals.
• Name/Address Change
• Written Evidence for Injections
• Out-of-state temporary practitioner reporting form
• Continuing Education (CE) Reporting Form

Volunteer Practice Forms

• Volunteer Sponsor
• Application for Registration to Volunteer Practice
• Continuing Education (CE) Credit Form for Volunteer Practice