Application & Instructions for Initial Licensure - Telemedicine

Log in to LaMED DashBoard to begin a new online initial application, complete a previously started (and saved) online initial application or to check the status of your completed online initial application.

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

Oath or Affirmation
This form must be notarized.  All yes answers must be accompanied by a sworn affidavit.  A sworn affidavit is an explanation (in applicant’s own words) that must be typed and notarized.  Note: If criminal history is found that you did not disclose, you will be required to submit a new Oath or Affirmation, a notarized affidavit as to why you did not disclose the information and a new processing fee equal to the initial licensure fee.  It is important that you answer question 3 accurately and truthfully. Do not take the advice of friends, lawyer, etc.

Third Party Authorization
This form must be notarized.  It authorizes LSBME to obtain information concerning the applicant from third parties.

Statement of Legal Name
Record your name as it appears on each document listed that applies to you.  This form must also be completed by any person whose name is not the same as the name on the birth certificate.  This form must be notarized.

FCVS
You must complete the FCVS application in order to apply for licensure.

Background Check - NOTE: If you are a physician on a current LSBME training permit, you do not need to do another background check when applying for full licensure.
LSBME conducts background checks as part of the application process.  Instructions and forms can be downloaded from our website or materials can be requested by:

  • Mail: LSBME, Attn: CBC, 630 Camp Street, New Orleans, LA 70130

  • E-Mail: lsbmecbc@lsbme.la.gov

  • Phone: (504) 568-6820

A telemedicine permit is required when a physician does not maintain an active Louisiana Medical License to engage in the practice of medicine in this state via telemedicine. Per §7503 of the rules, Telemedicine is defined as the practice of health care delivery, diagnosis, consultation, treatment and transfer of medical data by a physician using interactive telecommunication technology that enables the physician and patient at two locations separated by distance to interact via two-way video and audio transmissions simultaneously. Neither an electronic mail message between a physician and a patient, or a true consultation constitutes telemedicine for the purposes of this Part. A physician practicing by telemedicine may utilize interactive audio without the requirement of video if, after access and review of the patient’s medical records, the physician determines that he or she is able to meet the same standard of care as if the healthcare services were provided in person.

Once a permit is granted, it must be renewed annually.

Note: Interpretation of diagnostic studies/testing including pathology, echocardiograms, ultrasounds, intraoperative monitoring, radiological procedures, radiology or nuclear medicine requires a full Louisiana medical license.

Overview

The Louisiana State Board of Medical Examiners (the “Board”) annually processes hundreds of applications for licensure. This process involves the collection of credentials from the applicant as well as other sources.  The Board conducts a thorough evaluation of credentials, employment or work history, malpractice history and disciplinary history.  This process takes time - anywhere from a few weeks to several months, depending upon how quickly the applicant complies with what is requested and the nature of any problems requiring closer attention.  A permit is not guaranteed.  As such, each applicant is advised not to make commitments on loans, practice start dates, home purchases, etc. The Board will not accelerate one application at the expense of another nor will it waive any requirements in the screening process.  Once the application is received and reviewed, the analyst prepares and sends out a missing document report to request additional information and/or to return items that need corrections or clarifications.  Please wait at least ten days before calling to check on the status of the application.  The Board has no control over materials that must be requested from other agencies.  The Board shall have a reasonable period of time to collect and assimilate all required documents and information necessary to issue a permit.  If after submitting an application for a permit, an applicant has failed to respond or make an effort to pursue this permit for a period of six months, the application will be null and void and the applicant must reapply.  If you have been named in a malpractice suit, been sanctioned by another state or agency or have answered “yes” to any of the questions on the oath or affirmation page of the application, you must provide a detailed notarized narrative of the incident and anticipate a delay in the application process.  This includes offenses that may have occurred as a juvenile and that may have been expunged from your record.  The criminal background check can take months to process.  As such, it is suggested that you request the criminal background materials as soon as possible in the application process.

Qualifications for Permit

  • Be of good moral character and be at least 21 years of age.

  • 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.

  • Possess an unrestricted license to practice medicine issued by a State medical authority. The Board may deny a TMED permit if the applicant has had prior actions subject to investigation or has had actions involving staff privileges.

  • Is not enrolled in a medical residency or other post graduate medical training program.

  • Has completed the Telemedicine Rules Review Course (visit our website at www.lsbme.la.gov to view requirements for online completion).

  • Pay the appropriate fee of $300.00 Note:  Fees are not refundable. Renewal fee is $200.00 if paid prior to the expiration date, if not, the application fee of $300.00 is due.

  • Possess a Doctor of Medicine degree duly issued by a medical school approved by the board.  This diploma must be in English; if not, it must be accompanied by a certified translation into English.

  • Applicant must have completed one year of ACGME approved residency training in the United States or Canada in the same specialty;

  • Have taken and passed FLEX/USMLE Steps 1, 2, and 3, state board examination, National Boards Parts 1, 2, and 3, COMLEX-USA, NBOME or a combination thereof.  (There is no limit on step 1, four attempts on Step 2 and four on step 3).

  • If a medical competency examination has not been taken within 10 years of application, the applicant must be board certified or re-certified through the American Board of Medical Specialties within the past ten years or the applicant must take and pass SPEX (Special Purpose Examination) administered through the Federation of State Medical Boards, Inc.

Additional Requirements

Fees
Fee must be paid via credit/debit card (Visa, MasterCard or Discover only) .
​Fee is non-refundable.

  • Licensure- $300.00

Birth Certificate/Valid Visa

  • U.S. born citizen - submit a notarized copy of birth certificate

  • U.S. citizen not U.S. born - submit notarized copy of proof of citizenship (ie certificate of citizenship or consular report of birth abroad).  Naturalized citizen - submit a notarized copy of birth certificate and original Certificate of Naturalization.

  • Non U.S. citizen - submit a notarized copy of birth certificate and original current Visa issued by the U.S. Citizenship and Immigration Services.  (Acceptable Visas: H1B, J1, O1, NAFTA-TN or Employment Authorization, or Permanent Resident)

Marriage Certificate/Name Change
Application for licensure in a name other than what appears on the birth certificate requires a notarized copy of official documentation of name change (ie marriage certificate).

Notarization as a “true copy”
Request the notary to certify a copy of your birth certificate and/or marriage certificate as a “true and correct copy of the original”.  If the notary will not certify the document, you can attest that it is a “true and correct copy of the original”.  The notary can then notarize your signature.

Verification of Licenses in Other States
Verification of state licenses are required.  Contact the state board(s) directly to obtain verification of your license.  Please note, there may be a processing fee needed.

Other Information

Verification of Application/Licensure Status
Visit our website 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 our licensing department at licensing@lsbme.la.gov. To find the analyst directly assigned to your application, click on Contact Us.