Arizona Administrative Code
Title 4 - PROFESSIONS AND OCCUPATIONS
Chapter 16 - ARIZONA MEDICAL BOARD
Article 2 - LICENSURE
Section R4-16-203 - Application for Locum Tenens Registration

Universal Citation: AZ Admin Code R 4-16-203

Current through Register Vol. 30, No. 38, September 20, 2024

A. An applicant for a locum tenens registration to practice medicine for a maximum of 180 consecutive days in Arizona shall submit an application form available on request from the Board and on the Board's web site that provides the information required under R4-16-201(B).

B. In addition to the application form required under subsection (A), an applicant for a locum tenens registration to practice medicine shall have the the following submitted directly to the Board, electronically or in hard copy, by the primary source, ECFMG, Veridoc, or FCVS:

1. Official transcript or other authentication of graduation from a school of medicine;

2. Verification of completion of postgraduate training;

3. A statement completed by the sponsoring Arizona-licensed physician giving the reason for the request for issuance of the registration;

4. Verification of ECFMG certification if the applicant graduated from an unap-proved school of medicine; and

5. Verification of licensure from every state in which the applicant has ever held a medical license.

C. In addition to the application form required under subsection (A), an applicant for a locum tenens registration to practice medicine shall submit the following:

1. Documentation listed under A.R.S. § 41-1080(A) showing that the applicant's presence in the U.S. is authorized under federal law;

2. A full set of fingerprints and the charge specified in R4-16-205;

3. A copy of a government-issued photo identification; and

4. The fee specified under R4-16-205.

Disclaimer: These regulations may not be the most recent version. Arizona may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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