Get Doh-238 2011-2026

This guide provides clear instructions for completing the DOH-238 application for Certificate of Qualification. Follow these steps to ensure your application is accurately filled out and submitted correctly.

Follow the steps to complete the DOH-238 application effectively.

1. Click ‘Get Form’ button to obtain the DOH-238 application form and open it in the designated editor.
2. Fill in your personal information in Section 1. This includes your last name, first name, middle initial, home address, and contact details such as telephone numbers and email address.
3. In Section 2, provide details of your graduate and professional education. List all medical schools, colleges, and universities you attended in chronological order, including names, locations, majors, and degrees received.
4. Complete Section 3 by listing your board certifications. Include the abbreviation for the board and specialty, and the dates you were certified and recertified. Attach copies of your certificates as required.
5. In Section 4, describe your qualifications for board certification. Include the training and experience relevant to the board examination and detail your internships, residencies, and fellowships.
6. Section 5 addresses your licensure. Indicate whether you are licensed to practice in New York State or any other state. Provide your license type, number, and expiration date.
7. Detail your postdoctoral training and experience in Section 6. List all positions held, including institution names and addresses, your title, and describe your responsibilities.
8. For Section 7, enumerate your current employment. Include the name and description of the institution, job title, dates of employment, and any relevant identification numbers such as NYS permit or CLIA number.
9. Section 8 requires you to check off the categories for which you are seeking certification. Ensure you review the requirements carefully and mark all applicable categories.
10. In Section 9, respond to the certification questions regarding any violations, convictions, or license issues. Attach additional sheets if necessary for detailed explanations.
11. Sign and date the application form as indicated, confirming the accuracy and truthfulness of the information provided.
12. Submit your completed application along with the $40.00 application fee, a current curriculum vitae, and any supporting documentation to the designated address for processing.

Start completing the DOH-238 application online today to ensure your qualifications are recognized.