Information, Forms and Fees

Downloaded forms must be completed and mailed with appropriate fees to the Board office. Do not fax forms -- original signatures are needed for the files.

Note and follow all instructions for most efficient processing.

Feel free to contact the Board office with any questions!

General Information

 
Requirements to become a North Carolina Licensed Optician
Information about the ways an individual becomes a licensed optician in North Carolina.
None
 
pdf Board Election Sample Nomination Letter
Example of nomination letter used to submit NC-licensed optician's name for a Board election ballot.
None
 
pdf October 2016 License Exam Statistics
 

Business

 
Word Document Business Registration
Application to register optical place of business in North Carolina.
$75
 
Word Document Optician-In-Charge
Application to register Optician-In-Charge (OIC) of business.
$50
 
Word Document Contact_Lens_Release_Form_Sample
Information required by law to be presented to customers each time contact lenses are dispensed. Businesses can complete with business-specific info.
None

Training

 
Application: Training Establishment Registration (FORM ONLY)
Application to register a business or practice as a training establishment to accept trainees. Form only, for use in location or trainer roster changes. (No fee due if only changing trainer roster.)
$35
 
Application: Training Establishment Information & Registration Packet for Apprentices'
Information on Apprenticeship and Internship training programs, and form to register a business or practice as a training establishment to accept trainees.
$35
 
Application: Apprenticeship Registration after November 2016
Application to register to serve in 2 1/2 year Apprenticeship program.
$35
 
Application: Apprenticeship Registration before November 2016
Application to register to serve in 3 1/2 year Apprenticeship program.
$35
 
Application: Internship Registration
Application to register to serve 6-month internship, one of final steps to licensure as a dispensing optician in the state.
$35
 
Form: Training Documentation
Documentation form must be completed by trainer of record when trainee ends employment, or changes trainers or training establishments so that time served is recorded/tracked.
None
 
Form: Apprenticeship Certification of Completion
Certification form must be completed by trainer of record when trainee completes Apprenticeship (both on-the-job training time and certificate program).
None
 
Form: Internship Certification of Completion
Certification form must be completed by trainer of record when trainee completes Internship.
None
 
Internship Information Packet
Information for Intern regarding the 6-month training - seen as the final education/information dissemination & review period for trainers & trainees before Exam is complete and a license is issued.
None
 
Apprenticeship Information Packet
Information for Apprentice regarding the 2 1/2 & 3 1/2 year on-the-job training, certificate programs, and the proficiencies expected of a NC-licensed Optician.
None
 
Radiuscope
Information on, and instructions for use of the radiuscope.
None
 
Keratometer
Information on, and instructions for use of the keratometer.
None

Exam

 
In-State-Application for Admission to Examination in Ophthalmic Dispensing
Application to take Licensure Exam; eligibility based on completion of (1) Associate's Degree (AAS) in Opticianry or (2) the Board's 3 1/2 Apprenticeship program.
$300
 
Application for License - from a Licensed State
Application for licensure as a NC dispensing optician, by waiver of the Exam; eligibility based on license from another state.
$300
 
Application for Exam Admission - from a Non-Licensed State
Application to take Exam; eligibility based on practical experience & training from non-licensed state.
$300
 
Exam Retake Application
Application to retake Exam; eligible by prior unsuccessful completion of exam.
$300

Licensure

 

 
Application for License - Military training/Spouse
Application for licensure as a NC dispensing optician, by waiver of the Exam; eligibility based on Military training and experience or Spouse of military personnel with optical training.
$300
 
Application Application: 2017 License Renewal
Proper renewal constitutes this form, proof of attendance at required ConEd hours, and the $150 renewal fee. Renewals received after January 15th are subject to the $75 late fee, in addition to the renewal fee. ($150 for renewal and $75 late fee).
$150
 
Application Application: 2016 License Renewal
Application to renew Optician's license for 2016. Completed form must be submitted with applicable continuing education hours and fees ($100 for renewal and $75 late fee).
$175
 
Application: 2015 License Renewal
Application to renew Optician's license for 2015. Completed form must be submitted with applicable continuing education hours and fees ($100 for renewal and $75 late fee).
$175
 
Application: 2014 License Renewal
Application to renew Optician's license for 2014. Completed form must be submitted with proof of required continuing education hours and fees ($100 for renewal and $150 late fee).
$250

Continuing Education

 
Form: Continuing Education Seminar Certification
None
 
CE Seminar: Security Measures
Required security measures for CE events.
None

Miscellaneous

 
Duplicate License Request: A written request must be received in the office with fee. For a duplicate license with a name change, the original license and all duplicates must be surrendered to the Board office along with documentation supporting request. (Marriage, divorce, etc)
$100
 
Law/Rules of NC Relating to Opticians: A written request must be received in the office with check or money order.
$10
 
E-Mail Address List of NC Licensed Opticians: A written request must be received in the office with check or money order.
$35
 
Mailing Address List of NC Licensed Opticians, Interns, and Apprentices: A written request must be received in the office with check or money order. (Note: Print-ready list fits Avery #5160 labels.)
$35
 
Mailing Address Labels of NC Licensed Opticians, Interns, and Apprentices: A written request must be received in the office with check or money order.
$70
 
License Verification: In writing, licensees must identify to whom the verification should be addressed, and any specific information it should contain; otherwise the verification will contain licensure number and date; licensee's eligibility credentials; and expiration date of license. Fee should be submitted with written request. Licensees will receive copy of verification produced.
$15