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ARIZONA MEDICAL BOARD POSTGRADUATE TRAINING VERIFICATION FORM AUTHORIZATION The Arizona Medical Board requires all applicants for licensure to obtain verification of all postgraduate training programs attended. This form must be completed by the Program Director. This is authorization to release any information in your files of record favorable or otherwise DIRECTLY to the Arizona Medical Board. Authorization may be sent via mail or fax to 9545 E Doubletree Ranch Road Scottsdale AZ 85258 or 480 551-2704. First Name Last Name Signature Date Important - Program Participation Report incomplete postgraduate years PGY separately from those that were successfully completed* If the postgraduate year is currently in progress report the expected completion date in the To field. Report internships residencies and fellowships separately. PG Year Department/Specialty Internship Residency Fellowship From To Successfully Completed mm/dd/yy Yes No In Progress Affix Training Program Seal Here This pro....

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How to fill out the Bomex online

The Bomex form is essential for verifying postgraduate training for licensure applicants with the Arizona Medical Board. This guide will help you navigate the form with ease, ensuring that all necessary information is accurately provided.

Follow the steps to complete the Bomex form correctly

  1. Press the ‘Get Form’ button to access the Bomex online, allowing you to fill out the document seamlessly.
  2. Begin by entering your first name and last name in the designated fields at the top of the form.
  3. Provide your signature and the date in the appropriate sections, confirming your authorization for information release.
  4. For postgraduate training reporting, detail each postgraduate year (PGY), specifying any years that were incomplete separately from those completed.
  5. In the 'PG Year' section, indicate the year of your training. Specify the department or specialty and select the type of training: internship, residency, or fellowship.
  6. For each training period, fill in the 'From' and 'To' dates. If the training year is currently in progress, report the expected completion date.
  7. Indicate whether each training year was successfully completed by selecting 'Yes,' 'No,' or 'In Progress.'
  8. Repeat steps 5-7 for any additional postgraduate years, ensuring all sections are accurately filled out.
  9. Affix the training program seal in the designated space on the form.
  10. At the end of the form, provide the name and title of the person completing the form, along with their institution's address, phone, and fax number.
  11. Finally, save your changes, download a copy, print the completed form, or share it as needed.

Complete and submit your documents online today for a streamlined process.

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Filing a complaint with the Medical Board of Arizona involves completing a specific form and providing detailed information about your concerns. You can submit your complaint online or by mail, ensuring you include all relevant facts and documentation. Using Bomex aids in formalizing your complaint, making sure all necessary details are captured efficiently. For additional assistance, USLegalForms offers resources to help you construct a clear and effective complaint.

To file a beneficial ownership register, you should gather the required information about the individuals who own or control your business. With Bomex, you can easily input this data into an organized platform. Once you've submitted your register, it becomes part of the public record, which promotes transparency. USLegalForms provides tools and support to guide you through this process effectively.

Yes, if your LLC meets certain criteria, it must file a beneficial ownership report. This requirement is designed to enhance transparency and accountability. Using Bomex helps ensure you comply with federal regulations while keeping your business's ownership information secure. You can rely on USLegalForms to help you navigate this requirement seamlessly.

Yes, you can file your beneficial ownership information, known as BOI, by yourself using the Bomex system. The process is user-friendly and allows you to submit the necessary documents without needing professional help. However, it's essential to understand the requirements thoroughly to avoid mistakes. If you prefer guidance, USLegalForms offers resources that can assist you in ensuring proper submission.

Verification of Arizona license to practice PT and certification to work as a PTA may be ascertained on the eLicensing website. Information can also be obtained by calling our office at 602-274-0236.

Look up the physician license information on your Arizona doctor at the official website of the AZ Medical Board. Find additional information on his/her Education and Training, whether there are any AZ Board investigations, and Malpractice / Criminal information. Use Doctor Search for doctor license lookup.

Look up the physician license information on your Arizona doctor at the official website of the AZ Medical Board. Find additional information on his/her Education and Training, whether there are any AZ Board investigations, and Malpractice / Criminal information. Use Doctor Search for doctor license lookup.

Cara M. Christ, M.D., M.S. became Director for the Arizona Department of Health Services in May 2015.

AZ Medical Board - Regulation.

Check Doctor Accreditations A state or local occupational and professional licensing board will be able to give you this information. Use the American Board of Medical Specialties (ABMS) Certification Matters lookup to find out if a doctor is board-certified in the appropriate specialty.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232