(1) An
applicant who has been the subject of any adverse action, including the
imposition of a civil or criminal penalty, is not qualified for an Oregon
authorization to practice until the Office determines the scope and
applicability of the disciplinary action as it relates to the applicant's
fitness to practice or use a professional title under an Office-administered
program. The disciplinary record may include, but is not limited to, actions
imposed from:
(a) An Oregon health
professional regulatory board as defined in ORS
676.160;
(b) A regulatory authority in
Oregon or another state;
(c) A
regulatory authority in another country or territory.
(2) Pursuant to ORS
181A.195,
and in accordance with OAR
125-007-0200 through
127-007-0330, the Office may
determine an applicant's fitness to practice in accordance with ORS
181A.195
and
670.280.
(3) Material misrepresentation or
material errors of fact on an application or renewal are grounds for
disqualification of examination or discipline under ORS
676.612,
or both.
(4) Application or
renewal for an authorization issued for any program administered by the Office
shall be made on forms prescribed by the Office.
(5) To be accepted and processed, an
application must have the applicant's:
(a)
Legal name, address and telephone number;
(b) Date of birth;
(c) Signature
(d) Date of application;
(e) Social Security or Individual Taxpayer
Identification number as required by ORS
25.785,
305.385,
42 USC Sec.
405(c)(2)(C)(i), and 42 USC Sec.
666(a)(13). Failure to provide the
Social Security or Individual Taxpayer Identification number will be a basis to
refuse to accept the application or to issue an authorization. This information
will be used for child-support enforcement and tax-administration
purposes.
(f) Disclosure of any
active or inactive disciplinary action, voluntary resignation of a certificate,
license, permit or registration or sanction related to authorization imposed
upon the applicant by any state or country regulatory authority;
(g) Disclosure of any active or inactive
certificate, license, permit or registration issued by Oregon or another state;
(h) Payment for the exact amount
of required fees; and
(i) All
additional information required by the Office.
(6) An applicant may be required to provide
two forms of original identification issued by a federal, state or local
government agency. The Office will consider other forms of identification if
the procedures used in issuing the identification are sufficient to prove the
applicant's identity, and it contains security features that are sufficient to
prevent alteration or counterfeiting. Acceptable identification includes, but
is not limited to:
(a) An original or
certified copy of birth certificate. The Office will not accept a
hospital-issued birth certificate, hospital card or birth registration or
baptismal certificate.
(b) A
United States passport not expired more than five years.
(c) A United States passport card not expired
more than five years.
(d) U.S.
Territory passport not expired more than five years.
(e) Tribal ID card from a federally
recognized tribe.
(f) Certificate
of Citizenship (N560 and N561).
(g) Certificate of Naturalization (N550, N570
and N578).
(h) U.S. Citizen
Identification Card (I-197 and I-179).
(i) U.S. Military documents including:
(A) Military or Armed Forces ID Card;
(B) Military Common Access Card;
or
(C) U.S. Uniform Services ID
and Privileges Card (DD1173 and DD1173-1).
(j) Noncitizen resident card, such as a Green
Card, or Permanent Resident Card (I-551).
(k) Valid government-issued driver's license,
instruction permit or identification card that contains the applicant's
photograph.
(l) Concealed weapon
permit or concealed handgun license, not expired more than one year.
(m) United States-issued Social Security
card, and any documentation required to authenticate the identity of the
applicant.
(n) Oregon
medical-marijuana card.
(7) The Office will not accept a document as
proof of identity and date of birth if the Office has reason to believe the
document is not valid. The Office may request an applicant present additional
proof of identity.
(8) At least
one form of identification provided from the approved list in subsection (6) of
this rule must be photographic.
Notes
Or. Admin. R.
331-030-0000
HLO 1-2004, f. & cert.
ef. 2-13-04; HLA 12-2008(Temp), f. 11-28-08, cert. ef. 12-1-08 thru 4-30-09;
Administrative correction 5-20-09; HLA 1-2009, f. & cert. ef. 6-1-09;
HLO
71-2018, amend filed 04/30/2018, effective
5/1/2018;
HLO
75-2018, minor correction filed 05/30/2018, effective
5/30/2018;
HLO
7-2022, minor correction filed 04/26/2022, effective
4/26/2022
Publications: Forms referenced are available from the
agency.
Statutory/Other Authority: ORS
25.785,
ORS
181A.195,
ORS
305.385,
42 USC §
405(C)(2)(C)(i), 42 USC
§ 666(a)(13), ORS
670.280,
ORS
676.565,
ORS
676.615, ORS
681.700-681.730
& Senate Bill 1560 (2022)
Statutes/Other Implemented: ORS
25.785,
ORS
181A.195,
ORS
305.385,
42 USC §
405(C)(2)(C)(i), 42 USC
§ 666(a)(13), ORS
670.280,
ORS
676.565,
ORS
676.615, ORS
681.700-681.730
& Senate Bill 1560 (2022)