All applicants for licensure must complete this form and submit it with the appropriate fee ($108) directly to the Office of the Professions at the address at the end of this form. The $108 fee is the total of the application fee ($50) plus the fee for your first registration period ($58). The application portion of the fee is not refundable. You must answer all questions and provide all information requested unless otherwise indicated. Failure to complete all required parts of the application will delay its review.
Before you begin the application, you should review the requirements for licensure as an ophthalmic dispenser at http://www.op.nysed.gov/prof/od/odlic.htm. Please take a moment to review the list of necessary information you will need to complete this initial application form.
- Contact Information, including mail & email addresses and phone number(s).
- Information about any criminal (misdemeanor or felony) or professional disciplinary action. You will have the opportunity to upload relevant documents.
- Educational history, including degrees, locations, dates and exam scores.
- Professional experience, including details about any other professional licenses held.
- Payment information ($108 payment is only accepted by MasterCard, Visa, or American Express).
- To save and return to the application you must have a Social Security Number.
If you require assistance with the online application, please email OPOnlineApplications@nysed.gov.
Once NYSED has received this initial application form and payment electronically, you will receive an email indicating the document and payment have been received. Please retain this email notification as your proof of payment. It is the applicant's responsibility to follow up with any person or organization that needs to send us documents.