Submit New Application

Survey Visit Documentation Application

You are sent an email notification approximately three months prior to your survey due date that includes notice that you must submit documentation at least two months prior to your confirmed survey date. You may upload your documents here and submit the application instead of sending to the Board in an email.

Name

Phone

Alt Phone

Program Director

Address

City

State

Zipcode

Mailing Address

Address

City

State

Zipcode

Program Policies

Attendance

Behavioral Expectations

Course requirements with satisfactory progress standards

Criminal history checks

Dress Code

Cancellation and refunds

Administration of examinations

Faculty

Orientation Checklist

Faculty Evaluations Most recent evals for faculty (when applicable)

Clinical Sites

Academic/Clinical site affiliation agreements

Financial Documents

Evidence of Financial Viability For privately owned programs:

Business Practices Advertising, sales, collection, credit or other business practice are conducted in a manner that does not violate ORS 646.608

Current Enrollment and Disclosure

Current enrollment agreement and disclosure statement

Student program/course evaluation form

Blank copy of Student program/course evaluation form completed by students at the end of program

Affidavit

I hereby verify that I understand and agree with the statements contained herein and the above information is true and correct.

By Submitting

I hereby verify that I understand and agree with the statements contained herein and the above information is true and correct.

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