Predetermination
Pursuant to
2017 Wisconsin Act 278, beginning August 1, 2018, prior to submitting an application for a credential, an individual may apply to the Department for a determination of whether the individual would be disqualified from obtaining the credential due to his or her conviction record. To apply for a predetermination, please fill out
Form #3085 and submit all required documentation specified on the form. Pursuant to
Wis. Stat. §
111.335(4)(e), the offenses or kinds of offenses that may result in a refusal, bar, or termination of licensure are published under Additional Resources on the left side of this page.
License Information
Fee Reduction
Pursuant to 2017 Wisconsin Act 319, beginning August 1, 2018, an applicant for an initial credential may apply for a reduction of the initial credential fee that is equal to 10% of the initial fee. Qualification is based on the federal adjusted gross income being at or below 180% of the federal poverty guideline prescribed for the applicant's family household size by the United States Department of Health and Human Services. To determine eligibility please visit the United States Department of Health and Human Services website at https://aspe.hhs.gov/poverty-guidelines, prior to submitting Form 3217.
Per
Wis. Stat. § 440.08 (2), the required renewal date for the Optometrist credential is 12/14/odd years. Should you receive your initial credential in the months leading up to this date, you are still required to renew your license by the statutorily defined date.
Pre-Credential Education Information
Applicants must have graduated from an accredited optometric college.
Application for Certification for DPA/TPA
-
Diagnostic Pharmaceutical Agent (DPA) Certificate: An optometrist may obtain a DPA certificate if the following requirements are met:
- A plan is established for the referral of patients who experience adverse reactions from the application of topical ocular diagnostic pharmaceutical agents to appropriate medical services;
- Successfully complete 60 classroom hours of study in general and ocular pharmacology as it relates to optometry, 30 of which must be in ocular pharmacology;
- Successfully complete the clinical pharmacology exam of national boards; Parts I and II of the National Board exam administered after 1986, or an approved exam through the optometry school which provided the 60 classroom hours; and
- Submittal of a complete application with required documentation. No fee is charged for a DPA certificate.
-
Therapeutic Pharmaceutical Agent (TPA) Certificate: An optometrist may obtain a TPA certificate if the following requirements are met:
- DPA certification has been granted.
- Successful completion of 100 hours of approved study and the examination offered by the course provider in the use of therapeutic pharmaceutical agents and the removal of superficial foreign bodies from an eye or an appendage to the eye; or successfully complete the TMOD examination; and
- Submittal of a complete application with required documentation. No fee is charged for a TPA certificate.
In order to practice with therapeutic pharmaceutical agents that are controlled substances, an optometrist must obtain a
DEA number.
Application for Licensure
| Form | Description |
|---|
|
598
| Application For Optometrist License |
| 3217 | Application for Fee Reduction (If applying for a fee reduction, this form must accompany Form #598.) |
|
2829
| Malpractice Suits or Claims Form (If applicable) |
| 3085 | Application for Predetermination |
|
2252
| Convictions and Pending Charges |
|
3071 | Fax Payment Form |
Application for Certification for DPA/TPA
| Form | Description |
|---|
|
1161 | DPA/TPA Certification Application |
|
1728 | TPA Adverse Reaction Report |