The Washington Osteopathic Physician and Surgeon License application is the form osteopathic medical school graduates file with the Washington Board of Osteopathic Medicine and Surgery to earn the legal right to practice medicine in Washington State. Allopathic doctors (MDs) do not use this form, and they must instead apply through the Washington State Medical Quality Assurance Commission.
This single application decides whether you can see patients, write prescriptions, and bill for care in Washington. A small slip, like a gap in your work history or a missing signature, can stall your file for months, and the Board recommends submitting at least 60 days before your planned start date because practice is not allowed before your license is issued. Roughly 9 in 10 physician applications hit delays from missing primary-source documents, so the goal here is to get it right the first time.
Here is what you will learn in this guide:
- 📋 What the form is, who must file it, and the law behind it
- 🗂️ Every document and ID number you need before you start
- ✍️ A line-by-line walkthrough of the Uniform Application and the Washington Addendum
- 👥 Three full filled-out examples from real-world filers
- ⚠️ The exact mistakes that get applications rejected and how to dodge them
What the Form Is and Who Must File It
The Osteopathic Physician and Surgeon License application is your formal request to the Washington Board of Osteopathic Medicine and Surgery, often called BOMS, for permission to practice osteopathic medicine. The Board sits inside the Washington State Department of Health (DOH) in Olympia, and it is the only agency that can grant a DO license in the state. The form is built around the national Uniform Application for Physician State Licensure (UA), plus a Washington-specific addendum.
This application is for osteopathic medical school graduates only. If you hold an MD instead of a DO, you are in the wrong place, and you must apply to the Medical Commission. The law that requires and governs this license is chapter 18.57 RCW, the Osteopathic Medicine and Surgery Act, with the detailed rules spelled out in chapter 246-853 WAC. Ignoring these statutes is not an option, because practicing without a valid license is a crime, and the most direct consequence is that the Board can deny your application and refer you for prosecution. For example, Dr. Helena Cruz, a DO moving from Oregon, learned she could not see a single patient until her Washington license printed, even though she had practiced for years next door.
The form also connects to several other rules and bodies. The Uniform Disciplinary Act, chapter 18.130 RCW, controls how the Board judges your fitness and how it disciplines licensees. A common misconception is that this form is “just paperwork,” when in reality every answer is a sworn statement that can later support discipline if it proves false.
Before You Start: Documents and Information You Need
Gather everything below before you open the online Uniform Application, because the form asks you to account for every month since you graduated medical school, and stopping to hunt for dates invites errors. Missing even one item makes your file incomplete, and the Board will not review an incomplete file.
- Social Security number. State and federal law require it, and an ITIN or Canadian SIN cannot be substituted. Without it, your application cannot move forward.
- Legal name proof. Your birth certificate, marriage certificate, or court order, because using any name other than your legal name can get your application denied.
- Osteopathic school transcript details. Your school, degree, and graduation date, since the transcript must come straight from your COCA-accredited school.
- Exam scores. Your COMLEX-USA (NBOME) or USMLE/FLEX results, because the Board verifies these before licensing you.
- Postgraduate training records. The names, dates, and directors of every internship, residency, and fellowship, so the Board can confirm you finished at least one approved year.
- Full work and activity history. Every job and non-working gap since graduation, because the Chronology of Activities cannot have any gaps.
- All prior license numbers. Every healthcare license you have ever held in the U.S. or Canada, active or inactive, since each must be verified by its issuing board.
- Malpractice claim records. Final disposition documents for any suit or judgment, because you must attach proof of the outcome for each case.
- A 2” x 2” passport photo. Taken within the last six months, head and shoulders only, since proofs, negatives, and digital photos are not accepted.
- NPI number. Your National Provider Identifier if you have one, which speeds Medicare and Medicaid billing later.
Where to Get the Form and How to Access It
The Board uses the online Uniform Application for Physician State Licensure, hosted by the Federation of State Medical Boards (FSMB), not a downloadable PDF you mail in by itself. You create an account on the FSMB portal, click the UA icon, and select the Washington Board of Osteopathic Medicine and Surgery as your destination board. The current instructions and addendum carry a revision date of October 2025, so confirm you are using that version before you begin.
Alongside the online UA, you must complete the Washington Addendum packet, which includes the Application Questions, Personal Data Questions, Applicant’s Attestation, the notarized UA Affidavit, and, for trainees, the Training Appointment Verification. These addendum forms travel by mail to Olympia, while the core UA stays online. For example, Dr. Marcus Bell finished his online UA in one sitting but waited two weeks for his notary appointment before he could mail the affidavit.
You can also speed credential checks through the Federation Credentials Verification Service (FCVS), which gathers your identity, school, training, and exam records into one reusable profile. If you have ever applied in another state through the UA, your stored profile can be sent to Washington once you finish the state-specific pieces. A common misconception is that FCVS replaces the application; it does not, and you must still complete the full Washington UA and addendum even when FCVS handles your documents.
Step-by-Step: How to Fill Out the Uniform Application and Washington Addendum Line by Line
This is the heart of the application. Work through each section in the order it appears, and remember that everything you type becomes a sworn statement under penalty of perjury.
1. Application Type: Full License or Limited License
The form first asks which credential you want, with checkboxes for Full License and Limited License. Choose Full License if you have finished training and want to practice on your own, or Limited License if you are still in a Washington postgraduate program. Check only one box, and match it to your real situation. Dr. Helena Cruz, who finished residency in Oregon, checks Full License.
What if you are a brand-new graduate entering a Washington residency this July? Then you check Limited License, because that credential lets you practice only inside your training program and only under a supervising physician licensed under chapter 18.57 or chapter 18.71 RCW. A common mistake is checking Full License while still in training, and the direct consequence is a rejected application plus a non-refundable lost fee. Many filers wrongly believe a limited license lets them moonlight outside the program, but it does not, and practicing outside your training breaks the terms of the license.
2. Basis for Application: Endorsement Type
Next you pick the exam pathway with three boxes: National Board Endorsement, FLEX Endorsement, or USMLE Endorsement. Check the one that matches the exam you actually passed, because the Board verifies your scores against this choice. Most modern DO graduates check National Board Endorsement, since they sat for the COMLEX-USA through the NBOME. Marcus Bell, a 2019 DO graduate, checks National Board Endorsement.
What if you took a mix, like USMLE Step 1 but COMLEX later? You select the complete exam series you finished and passed, and you list the details in the exam section. Under WAC 246-853-020, accepted exams include COMLEX Levels 1, 2, and 3, USMLE Steps 1, 2, and 3, and older FLEX scores. A common mistake is checking USMLE when only COMLEX scores exist, which triggers a verification mismatch and a hold. Some filers think any passing exam counts, but the Board only accepts the specific exams in the rule with their minimum scores.
3. Identification and Legal Name
This page asks for your full legal name, date of birth, and Social Security number. Enter your legal name exactly as it appears on your birth certificate, marriage certificate, or court order, because the Board cross-checks it and may ask you to prove it. Type your Social Security number in full, since state and federal law require it. Helena enters Helena Marie Cruz and her SSN as printed on her card.
What if your name changed when you married or by court order? You list every prior name in the Alternate Name section and attach proof of the change under WAC 246-12-300. A common mistake is entering a nickname or shortened name, and the direct consequence is that your application may be denied for using a name other than your legal name. People often think the name on their diploma is enough, but the Board ties your identity to your official vital records, not your school records.
4. Addresses: Home, Business, and Public Access
The UA asks for a home address and a separate business or training address, and it makes you set both a Board Contact and a Public Access selection. Provide complete addresses with city, state, ZIP code, and country, because the Board Contact address becomes your permanent address of record. You may use the same address for both selections if you wish. Marcus enters his Seattle home address for Board Contact and his clinic address for Public Access.
What if you move during the application? You must notify DOH in writing under WAC 246-12-310, because the Board mails license documents to the address on file. A common mistake is leaving the country field blank, which can stall electronic processing. Many filers worry their home address becomes public, but the current address and phone of a provider governed under chapter 18.130 RCW is not public information.
5. Other Professional Licenses
Here you list every other professional license you have ever held, such as nurse, EMT, or physician assistant, active or inactive, in the U.S. or Canada. Enter each one, because each license must be verified by its granting board. Do not, however, enter your MD or DO license here, since that data flows directly from state boards into the FSMB system. Helena lists her former EMT certification but leaves her DO license to populate on its own.
What if you hold a license in a country outside the U.S. or Canada? You provide that information on a separate sheet of paper sent to the Board. A common mistake is typing a DO license number under “Other,” and the direct consequence is duplicate or conflicting records that delay your file. If you need a correction to the auto-filled DO data, you email ua@fsmb.org, and changes can take one to three business days. People often think inactive licenses can be skipped, but the Board requires verification of every license ever held.
6. Chronology of Activities
This section makes you account for every period from medical school graduation to today, including non-working time. Fill in each activity with no gaps, using the first day of the month for start and end dates when you do not know the exact day. List military and locum tenens assignments separately by location. Marcus lists his residency, a one-year clinic job, and a three-month gap he spent caring for a parent.
What if you took time off to travel or recover? You still list it, because gaps are red flags the Board will question, and an unexplained gap can pause your review. Check the Staff Privileges box for every site where you held admitting privileges, and mark whether your time was clinical or administrative. A common mistake is leaving a gap blank, which is the single fastest way to get a follow-up request. Many filers think only paid medical work counts, but the Board wants a full timeline of all activities, working or not.
7. Malpractice and Professional Liability Claims
This page asks you to report all past and current liability claims or lawsuits filed against you. Report each one, and attach a copy of the final disposition for every case, including dismissals, because the Board needs the outcome, not just the claim. You may leave this page blank only if you truly have no claims. Helena, with one dismissed 2018 suit, lists it and attaches the dismissal order.
What if a case is still open? You report it as current and explain its status, since failing to disclose a pending suit looks like concealment. A common mistake is reporting the claim but omitting the disposition document, and the direct consequence is an incomplete file that will not be considered. Filers often believe a dismissed case is not worth listing, but the Board requires every claim, even those resolved in your favor.
8. Personal Data Questions (Washington Addendum)
The Washington Addendum poses 15 yes-or-no Personal Data Questions about your fitness to practice. Answer each truthfully, and for every “Yes” answer, attach a signed, dated explanation plus certified copies of all related judgments, orders, and agreements. These questions cover medical conditions that impair practice (Question 1), current substance use (Question 2), criminal history (Question 5), drug-law violations (Question 6), license discipline (Question 8), malpractice judgments (Question 10), and active investigations (Question 13), among others. Marcus answers No to all 15 and signs.
What if you have a medical or substance use condition that may affect safe practice? You contact the Washington Physician Health Program (WPHP) at 800-552-7236, which the Board treats as a safe haven in the process. A common mistake is answering “No” to a criminal-history question to hide an old charge, and the direct consequence under chapter 18.130 RCW can be denial or later revocation for a false statement. Many filers think a minor or dismissed conviction need not be reported, but Question 5 covers any plea, deferred sentence, or suspended sentence in any jurisdiction, so report it.
9. Applicant’s Attestation and Signature
The Attestation has you declare, under penalty of perjury under Washington law, that you are the person described, that you answered truthfully, and that you have read RCW 18.130.170 and RCW 18.130.180. Print your name in the declaration line, then sign and date it, because the Board cannot process the file without your signature. Helena prints Helena Marie Cruz, signs, and dates it 05/29/2026.
What if you are unsure whether you have read every rule? You read chapter 246-853 WAC and the Uniform Disciplinary Act first, because you are swearing that you have. A common mistake is leaving the date blank or signing in the wrong spot, which voids the attestation and stalls the file. Filers often treat this as a routine signature, but it is a sworn legal statement, and a false answer here can lead to prosecution.
10. UA Affidavit and Authorization for Release (Notarized)
This separate form must be signed in the presence of a notary public, with your 2” x 2” passport photo taped or glued in the box so the notary seal overlaps the bottom-left of the photo. Sign only in front of the notary, attach the photo, and have the notary complete the certification, because an un-notarized affidavit is rejected. Mail this form, not to FCVS, but to the Board at P.O. Box 47877, Olympia, WA 98504-7877. Marcus visits his bank’s notary, signs, and affixes a fresh photo.
What if you are also using FCVS? You may notarize the separate FCVS affidavit at the same visit, but you send that one to FCVS and this one to the Board, since sending the UA affidavit to FCVS delays your license. A common mistake is using a digital or proof photo, and the direct consequence is rejection because only a recent passport-quality color print is accepted. People often think one notarized form covers both purposes, but the UA Affidavit and the FCVS Affidavit are separate documents with separate destinations.
11. Training Appointment Verification (Limited License Filers)
If you checked Limited License, your Washington program director must complete the Training Appointment Verification (Addendum 3), confirming your acceptance, program type, institution, and start date. Ask your director to fill it out and mail it straight to Osteopathic Credentialing, because documents that verify training cannot be accepted from you. The form also names the person responsible for your patient-care supervision. Dr. Priya Anand’s residency director completes it for her July start.
What if your program runs across two institutions? The director lists the sponsoring Washington institution and explains the arrangement, since the limited license ties to an approved Washington program. A common mistake is the applicant filling out and mailing this form personally, which makes it invalid because it must come from the originating source. Trainees often assume their match letter is enough, but the Board requires this specific verification form signed by the program director.
Three Filled-Out Examples Using Real Scenarios
Below are three common filers walking through the form from start to finish. Each shows what the person enters in the main sections.
Scenario 1: Dr. Priya Anand, a new DO graduate entering a Washington residency
| Form Section | What Priya Enters |
|---|---|
| Application Type | Limited License (Postgraduate Program) |
| Endorsement Type | National Board Endorsement (COMLEX) |
| Legal Name | Priya Rao Anand |
| Date of Birth / SSN | 07/12/1998 and full SSN |
| Osteopathic School | COCA-accredited DO school, graduated 05/2026 |
| Exams | COMLEX Levels 1 and 2 passed; Level 3 pending |
| Chronology of Activities | Medical school 2022–2026, no gaps |
| Training Verification | Completed by Seattle residency program director |
| Personal Data Questions | All 15 answered “No” |
| Fee | Limited license application fee, by check |
Scenario 2: Dr. Helena Cruz, an experienced DO relocating from Oregon
| Form Section | What Helena Enters |
|---|---|
| Application Type | Full License |
| Endorsement Type | USMLE Endorsement (Steps 1, 2, 3) |
| Legal Name / Alternate Name | Helena Marie Cruz; prior name Helena Marie Reyes with marriage certificate |
| Other Licenses | Oregon DO license (auto-filled), former EMT cert |
| Chronology of Activities | Residency 2010–2013, Oregon practice 2013–2026, no gaps |
| Malpractice Page | One 2018 suit, dismissed, with disposition attached |
| Personal Data Questions | All “No,” with malpractice explained on Q10 |
| Temporary Permit | Requested, since Oregon standards are equivalent |
| UA Affidavit | Notarized with fresh 2×2 photo |
| Fee | Full application, endorsement, and temporary permit fees |
Scenario 3: Dr. Marcus Bell, a DO using FCVS for verification
| Form Section | What Marcus Enters |
|---|---|
| Application Type | Full License |
| Endorsement Type | National Board Endorsement (COMLEX) |
| Legal Name | Marcus Tyrell Bell |
| FCVS Profile | Designates Washington BOMS to receive profile |
| School / Training / Exam Docs | Handled by FCVS, none mailed to Board |
| Chronology of Activities | Residency 2016–2019, clinic 2019–2026, 3-month gap explained |
| Other Licenses | Texas DO (auto-filled) |
| Personal Data Questions | All 15 answered “No” |
| UA Affidavit | Notarized, mailed to Board, not FCVS |
| Fee | Full application fee, by money order |
How to File the Completed Form
Washington uses a hybrid filing process: the core application is online, while signed and verified documents arrive by mail. Below is each channel you will use.
- Online (Uniform Application). File the UA through the FSMB portal, select the Washington Board of Osteopathic Medicine and Surgery, and pay the one-time UA service charge by card on the payment page. Processing of the online piece is immediate, and your receipt lives under the Payment link on the portal home page. Keep a screenshot of your submission as proof.
- Mail (affidavit, addendum, and fee). Mail your notarized UA Affidavit, completed addendum, supporting documents, and a check or money order for the non-refundable application fee to Department of Health, P.O. Box 1099, Olympia, WA 98507-1099. Pay by check or money order payable to the Department of Health. Expect initial review to take a few weeks, and keep a copy of everything plus your mailing receipt.
- Mail (later or program documents). Send documents not included with your initial packet, like the Training Appointment Verification, to Osteopathic Credentialing, P.O. Box 47877, Olympia, WA 98504-7877. There is no separate fee for these. Keep proof of mailing for your records.
- FCVS (credential verification). Build your profile on the FCVS portal, designate the Washington Board, and pay FCVS its own fee. FCVS then sends your school, training, and exam records directly. Save your FCVS ID number as proof.
See the online fee page for current amounts, and note that the Board recommends submitting at least 60 days before your intended start date because no practice is allowed before issuance.
What Happens After You File
After the Board receives your online UA, mailed affidavit, and fee, staff review your file for completeness and request anything missing. The Board independently pulls your American Osteopathic Information Association (AOIA) profile and a Washington State criminal background report, and it may require an FBI fingerprint-based check at your expense if you have lived in another state or have a Washington record. Verifications of your school, training, exams, and prior licenses must arrive from the originating sources, since the Board will not accept them from you.
If your file is clean and complete, the Board issues your full license and you may begin practicing. If you qualified for a one-time temporary permit, valid for 180 days, you may start work while the full review finishes, but only if you have no disciplinary history and no “Yes” answers to the Personal Data Questions. For example, Helena uses her temporary permit to begin at her Seattle clinic two weeks after filing while her Oregon equivalency is confirmed.
Once licensed, your obligations continue. Washington DOs must complete 150 hours of continuing medical education every three years under chapter 246-12 WAC and the osteopathic CE rules in WAC 246-853-060, with at least 60 hours of Category 1 credit, plus required suicide-prevention and opioid-prescribing training. A misconception is that licensure is “set and forget,” but failure to meet CME and renewal duties can lead to an inactive or disciplined license.
Mistakes to Avoid When Filling Out the Form
- Entering a nickname instead of your legal name, which can lead to denial.
- Leaving a gap in the Chronology of Activities, which triggers a follow-up request and delay.
- Checking Full License while still in a training program, which gets the application rejected.
- Selecting the wrong endorsement type for your exam, which causes a verification mismatch and hold.
- Typing your DO or MD license under “Other,” which creates conflicting records.
- Answering “No” to a criminal-history question to hide an old charge, which risks denial or revocation.
- Reporting a malpractice claim but omitting the final disposition, which makes the file incomplete.
- Using a digital or proof photo on the affidavit, which is rejected outright.
- Signing the UA Affidavit without a notary present, which voids it.
- Mailing the UA Affidavit to FCVS instead of the Board, which delays your license.
- Sending your own transcripts or verifications to the Board, which are not accepted from you.
- Submitting fewer than 60 days before your start date, which can leave you unable to work on time.
Do’s and Don’ts
Do’s
- Do submit at least 60 days early, because review and verification take weeks.
- Do use your exact legal name, since the Board ties your identity to vital records.
- Do account for every month since graduation, because gaps stall review.
- Do attach final disposition documents for every malpractice claim, since the outcome is required.
- Do answer all 15 Personal Data Questions honestly, because false answers support discipline.
- Do keep copies and mailing receipts, since they prove timely filing.
Don’ts
- Don’t practice before your license issues, because doing so is unlawful.
- Don’t send identity or credential documents yourself if you use FCVS, since FCVS handles them.
- Don’t enter your DO license under “Other,” because it auto-fills from state boards.
- Don’t skip inactive licenses, since every license ever held must be verified.
- Don’t use a name other than your legal name, because it can cause denial.
- Don’t notarize and mail the wrong affidavit to the wrong address, since it delays everything.
Pros and Cons of Filing on Your Own vs. With Help
| Filing on Your Own | Filing With a Service or FCVS |
|---|---|
| Saves money, since you avoid service fees | Costs more, because of added FCVS or consultant fees |
| Full control over your timeline and answers | Less hands-on, since a third party manages steps |
| Direct knowledge of your own file’s status | Reusable FCVS profile speeds future state applications |
| Risk of missing a document, which delays review | Lower risk of missing primary-source items |
| Slower if you are unfamiliar with the UA | Faster verification once your profile is built |
FAQs
Do I use this form if I hold an MD instead of a DO?
No. This application is for osteopathic graduates only, and MDs must apply through the Washington State Medical Quality Assurance Commission, a separate agency from the osteopathic Board.
Do I have to list a malpractice case that was dismissed?
Yes. Report every claim, even dismissed ones, and attach the final disposition document, because the Board requires the outcome of each case.
Do I write my maiden name or married name in the legal name field?
Yes, use your current legal name, and list your maiden name in the Alternate Name section with proof of the change under WAC 246-12-300.
Do I need a Social Security number to apply?
Yes. State and federal law require it, and an ITIN or Canadian SIN cannot be substituted on this application.
Do I check Full License or Limited License if I am starting a residency?
No, do not check Full License; check Limited License, since that credential covers practice inside a Washington training program under supervision.
Do I enter my DO license number under the “Other” licenses section?
No. Leave it out, because your DO license auto-fills from state boards, and entering it manually creates conflicting records.
Do I have to explain gaps in my work history?
Yes. The Chronology of Activities must have no gaps, so list every period, including non-working time, to avoid a follow-up request.
Do I need to use FCVS to apply?
No. FCVS is optional, but if you use it, you still must complete the full Washington Uniform Application and addendum.
Do I send my transcripts directly to the Board myself?
No. Documents verifying education or training must come from the originating source, since the Board will not accept them from you.
Do I need my photo notarized on the affidavit?
Yes. Sign the UA Affidavit in front of a notary with a recent 2” x 2” passport photo attached so the notary seal overlaps the photo.
Do I qualify for a temporary permit while I wait?
Yes, if you hold a license in a state with equivalent standards, have no disciplinary history, and answer “No” to all Personal Data Questions.
Do I have to report an old criminal charge that was dismissed?
Yes. Question 5 covers any plea, deferred, or suspended sentence in any jurisdiction, so report it with certified court documents.
Do I need to do continuing education after I am licensed?
Yes. Washington DOs must complete 150 CME hours every three years, including at least 60 Category 1 hours, plus required training topics.
Do I file before or after I move to Washington?
Yes, file early; the Board advises submitting at least 60 days before your start date, since you cannot practice before your license issues.
Related reading
- How to Fill Out the Washington DOH Medical License Application (MD) + FAQs
- How to Fill Out the Washington DOH Naturopathic Physician License Application + FAQs
- How to Fill Out the Washington DOH Pharmacist License Application + FAQs
- How to Fill Out the Washington DOH Physician Assistant License Application (2026 Guide) + FAQs
- How to Fill Out the Washington DOH Osteopathic Physician License Application (Revised October 2025)
- How to Fill Out the Arizona (AZ) Medical License Application (MD) + FAQs
- How to Fill Out Florida Medical License Application (MD) (w/Examples) + FAQs