Forms

License Application Packet

• Podiatrist Application Packet (pdf)
• Podiatric Hygienist Application Packet (pdf)

Licensing Renewal Forms & Submittal

On-line renewal forms with the required supporting documents can be submitted at: nvpodiatry.certemy.com.

Complaints

Pursuant to NRS 635.130 - The Board may take disciplinary action against a licensee for any of the following causes:

• The making of a false statement in any affidavit required of the applicant for application, examination or licensure pursuant to the provisions of this chapter.
• Lending the use of the holder’s name to an unlicensed person.
• If the holder is a podiatric physician, his permitting an unlicensed person in his employ to practice as a podiatry hygienist.
• Habitual indulgence in the use of alcohol or any controlled substance which impairs the intellect and judgment to such an extent as in the opinion of the Board incapacitates the holder in the performance of his professional duties.
• Conviction of a crime involving moral turpitude.
• Conviction of violating any of the provisions of NRS 616D.200, 616D.220, 616D.240 or 616D.300 to 616D.440, inclusive.
• Conduct which in the opinion of the Board disqualifies him to practice with safety to the public.
• The commission of fraud by or on behalf of the licensee regarding his license or practice.
• Gross incompetency.
• Affliction of the licensee with any mental or physical disorder which seriously impairs his competence as a podiatric physician or podiatry hygienist.
• False representation by or on behalf of the licensee regarding his practice.
• Unethical or unprofessional conduct.
• Willful or repeated violations of this chapter or regulations adopted by the Board.
• Willful violation of the regulations adopted by the State Board of Pharmacy.

Your complaint must fall under one of the above-referenced causes in order for the Board to take action.

• Complaint Form (pdf)
• Medical Authorization Form (pdf)