Licensure Application-Required Documents:

• Complete a Federation Credentials Verification Service (FCVS) on-line application. You will receive an e-mail from FCVS letting you know when to proceed with the Uniform Application;

• Complete the Uniform Application. Information that was provided in the FCVS application will automatically appear on the Uniform Application.  Those fields are shaded in gray and cannot be edited.  If you need to make any changes to that information, contact FCVS.  The Uniform Application includes:
  
  Uniform Application Form;
  
  Form #1:  Licensure Verification Form to verify all out of state licenses held.  The form should be forwarded to each state and/or Canadian province in which you hold or have ever held a license to practice medicine, whether the license is current or not.  The State licensing board will return the form directly to the State Medical Board of Ohio.  Some state boards charge a fee for completion of this form;
  
  Affidavit and Authorization for Release of Information (must be notarized and mailed to the State Medical Board of Ohio);

• Complete the Ohio Addendum. The form must be printed and mailed with the application fee of $335 to the State Medical Board of Ohio, 30 East Broad Street, 3rd Floor, Columbus, Ohio 43215.  Check should be made payable to Treasurer, State of Ohio.  The Addendum includes:
  
  Addendum Form;
  
  Criminal Offense Information Form if you answered “Yes” to Additional Information Questions #15 and/or #16;
  
  Two Certificates of Recommendation with Instructions;
  
  Employer Recommendation Form for your most recent employer(s) within the last five years;

• Request an AMA Physician Profile

• Complete a Criminal Background Check. You must use the services of a vendor that participates in the “National WebCheck”.  The Sheriff’s offices in most 88 Ohio counties participate in the “National WebCheck”.  A list of all vendors, searchable by county, is available. Request that the results be sent directly to the State Medical Board of Ohio.  The Medical Board will not accept the results from the applicant. If outside Ohio, contact the Medical Board to request the appropriate forms for your fingerprints to be processed at your local law enforcement agency.
  
  
• Request a TOEFL iBT score report, if applicable.