Podiatry Forms

Podiatric Physician

Podiatric Medical Radiological Technician

POD009 Application for Podiatric Medical Radiological Technician Registration (PDF)

Podiatric Practices

TDLR Complaint Sign (PDF)

Insurance plan complaints and information: Texas Department of Insurance - Physicians & Health Providers

Texas Medical Disclosure Panel - Rules and Forms related to Informed Consent. The Texas Medical Disclosure Panel publishes Rules and Forms related to "Informed Consent" under Title 25, Texas Administrative Code, Part 7, Chapter 601.

Reporting Medical Professional Liability Claims

Other Forms

Criminal History Evaluation Letter

Criminal History Questionnaire (PDF)

Disciplinary Action Questionnaire (PDF)

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

Request to Executive Director for Expired License Renewal (PDF)

POD010 Podiatry Duplicate License/Certificate/Permit Request and Change of Information Form (PDF)

Renewal Deadlines

Annual Renewal Deadlines by License / Registration Type: Deadline (@ Midnight): Renewal Method:
Podiatric Physician License (Texas DPM - Podiatric Physician) November 1st Online (Texas.Gov)
Radiology Technician Registration (RadTech - Xray) December 31st Paper Form
Hyperbaric Oxygen Registration (DPM - HBO) January 31st Paper Form
Nitrous Oxide Registration (DPM - N2O) January 31st Paper Form
Podiatry Resident License (DPM - Temporary) June 30 th Paper Form

Forms Policy

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."

File Viewing Information

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.