General Change of Address Information
- Please complete the address change form by providing all the requested information even if you have submitted an address before. Please type or print legibly. Fax or mail the completed form to the Oregon Medical Board.
- Per ORS 677.172 (3)(a), if you move out of Oregon, the Board will change your status to Inactive. Please submit a request in writing if you prefer to be placed at a Locum Tenens Status.
- OAR 847-008-0015 (5) Each licensee of the Board whose practice address of record is within 100 miles of the border of the State of Oregon and who intends to practice within Oregon shall quality for active registration status. Such licensee shall submit a statement to the Board attesting to practice in Oregon.
- The Board must have a current practice address and phone number; as well as, a current mailing address.
- Per ORS 677.172 (1), you are required to notify the Board of a change of location no later than 30 days after the change. Please keep us informed of your practice, residence, mailing address, and telephone numbers.
- The Board does not automatically reissue a new Certificate of Registration. The Board does not require the Certificate of Registration to show a licensee’s current address. Please indicate if you would like a duplicate certificate of registration on the address change form. If you require a faxed certificate you will be charged $5.20.
- PRACTICE AND MAILING ADDRESSES ARE PUBLIC INFORMATION.
- Please call us if you have any questions: 971-673-2700.
This form is in PDF format - You must have Adobe Reader to access it.
Locum Tenens Status
- As a licensee with Locum Tenens status, you are eligible to practice medicine in Oregon when you have notified the Board of the location and duration of your planned Oregon practice. You must provide the Board with timely notification of the location and duration of each Oregon practice prior to beginning such practice (OAR 847-008-0020 ).
- A licensee with Locum Tenens status may practice in Oregon for 180 days consecutively or intermittently within the biennial period. A licensee with Locum Tenens status who wishes to practice in Oregon for longer than 180 days in the biennium will need to reactivate their license to Active status. Contact the Board immediately to begin the reactivation process.
- Licensees with Locum Tenens status shall renew their license biennially. If you do not practice at least one day in Oregon during each biennium, you are no longer eligible for Locum Tenens status. Your license will be placed at Inactive status at the time of registration renewal.
- Volunteer Camp Physicians with Locum Tenens status may practice in Oregon for up to 14 days per year at a camp operated by a nonprofit organization.
(This form is in PDF format - You must have Adobe Reader to access it.)
Complete this form if you currently hold Locum Tenens Status and have an upcoming assignment.
OR
You have an upcoming assignment and you are requesting Locum Tenens Status instead of Inactive.
All other statuses will have to reactivate to obtain Locum Tenens Status.
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