Orthotists and Prosthetists Forms

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These forms are available for download in Adobe Acrobat .pdf format. Acrobat Reader is necessary to view .pdf files. If you need to obtain a copy of this program it is available as a free download for Windows or Macintosh operating systems.

Please note the following policy regarding the filing of forms which collect a person's individual information:

"An individual who completes and files this form with the Texas Department of Licensing and Regulation (the Department) is entitled to the following from the Department:

(1) to be informed about the information that the Department collects about the individual, upon the request of the individual and subject to a few exceptions;

(2) to receive and review the information, under Sections 552.021 and 552.023 of the Texas Government Code; and

(3) to have the Department correct information about the individual that is incorrect, under Section 559.004 of the Texas Government Code."

Orthotists and Prosthetists Forms

OPS001 Orthotists and Prosthetists License Application (725KB PDF)

OPS002 Orthotists and Prosthetists Professional Reference (44KB PDF)

OPS003 Orthotists and Prosthetists Supervision Agreement (41KB PDF)

OPS004 Attestation of Experience Providing Extensive Orthotic Care (46KB PDF)

OPS005 Attestation of Experience Providing Extensive Prosthetic Care (45KB PDF)

OPS006 Orthotists and Prosthetists Verification of Experience (71KB PDF)

OPS007 Orthotists and Prosthetists Notice of Change and Duplicate License (39KB PDF) revised May 2017

OPS008 Orthotists and Prosthetists Change of On-Site Practitioner in Charge (53KB PDF)

OPS009 Orthotists and Prosthetists Facility Accreditation Application (83KB PDF)

OPS010 Orthotists and Prosthetists Change of Facility Safety Manager (52KB PDF)

OPS011 Orthotic and/or Prosthetic Facility Name Change and Duplicate License Request (38KB PDF)

Other Forms

Disciplinary Action Questionnaire (98KB PDF)

Criminal History Questionnaire (63KB PDF)

Military Service Member, Military Veteran, or Military Spouse Supplemental Application (110KB PDF) - see Military Spouse Frequently Asked Questions

TDLR Complaint Sign (107KB PDF)

Request to Executive Director for Expired License Renewal (56KB PDF)

Criminal History Evaluation Letter