Application & Instructions for Initial Licensure - Visiting Physician Evaluation Permit

 

CLICK HERE TO BEGIN THE ONLINE APPLICATION PROCESS

     Click HERE to complete a previously started (and saved) online initial application.
     Click HERE to check the status of your completed online initial application.

To access a paper application, click HERE (available for a limited time)

 

The items listed below MUST be completed and mailed to the LSBME as part of the initial application process.

 

The board may issue a visiting physician evaluation temporary permit to an applicant physician to conduct a non-invasive evaluation of an individual located in Louisiana, who has given consent, provided that while acting under the authority of such permit in Louisiana such physician shall not utilize the results of his evaluation to treat any medical condition which he may determine such individual to suffer, or engage in any activity beyond the scope of authority specifically conferred by such permit.

 

Qualifications for Permit

  1. Be a citizen of the United States or possess valid and current legal authority to reside and work in the United States duly issued by the commissioner of the Immigration and Naturalization Service.
  2. Possess a doctor of medical or doctor of osteopathic degree duly issued by a medical or osteopathic school approved by the Board.
  3. Hold an unrestricted license to practice medicine issued by another state or country if not licensed and domiciled in the United States.

 

Application – submitted as a single set of documents as follows

  1. Confirmation that the evaluation sought to be performed is being undertaken with the consent of the individual to be evaluated
  2. Confirmation of the location and date where such evaluation is to be conducted.
  3. A copy of the applicant’s medical license issued by another state or country
  4. Oath or Affirmation relating to professional background
  5. Third party authorization for release of information
  6. Pay fee of $100.00 credit/debit card only

 

Please note

Work may not begin until the permit has been approved

 

Other Information

Verification of Application/Licensure Status - Visit our website at www.lsbme.la.gov and log on to your account to verify the progress/status of your application.

 

Communication with the Board

Mailing Address - LSBME, 630 Camp Street, New Orleans, LA 70130

Questions - Contact Sandra Broussard at (504) 568-7688 or sbroussard@lsbme.la.gov.