Transfer to NCOPE National Commission on Orthotic and Prosthetic Education (NCOPE)

Verification of Certificate / Licensure

Verification of Residency &
Certification of Completion Request Form

REQUEST FOR CERTIFICATE OF COMPLETION/STATE LICENSURE VERIFICATION FORM
Effective January 1, 2011, NCOPE will charge a fee of $25.00 for state licensure verification letters and certificates of completion reprints (all residents receive one certificate of completion when residency program is completed) Please do not send cash. Make checks and money orders payable to NCOPE. Mail completed form with payment to NCOPE. Requests take 2 weeks to process. NCOPE will notify you when request is received. All State Licensure Verification Letters will be forwarded directly to state licensure agency and a copy will be mailed to the requester.
Residency Information

Request Summary
(please check all that apply)
Rate Quantity Costs

$25.00
$0.00
$10.00
Total
For Office Use Only


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