Applicants with Health History

Applicants who answer “Yes” to any of the Health History questions on the application are required to submit the following documentation to the board office:

Self-Explanation – Applicants must submit a letter in your own words explaining the medical condition(s) or occurrence(s). Include a description of all treatments and diagnoses you have received for any condition(s)/impairment(s) you are/have been treated for. Include all medications prescribed and all physicians/counselors that have provided treatment.

Physician(s) Letter – Applicants must submit a statement from your treating physician(s)/counselor(s) for each condition you are/were being treated for and whether or not you are currently able to safely practice Medicine. The physician’s statement should include all DSM IIIR/ DSM IV, Axis I, II, and III diagnoses.