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APPLICATION FOR THE ISSUE OF A PERMIT TO PRACTICE OPTOMETRY ON THE BASIS OF A LEGAL AUTHORIZATION TO PRACTICE OUTSIDE QUÉBEC OR AN EQUIVALENCE OF DIPLOMA OR TRAINING 1. GENERAL INFORMATION
The holding of a doctorate in optometry from the Université de Montréal is required for the issue of a permit to practice optometry by the Ordre des optométristes du Québec and of special permits with respectto the use of medication. However, a person not holding such a doctorate who is authorized to practice optometry elsewhere in Canada or the United States or who considers that the diploma (s) held and/or training received is (are) equivalent to this doctorate may apply to have the Ordre issue such a permit if the person is able to establish that this authorization or equivalence is held inaccordance with the applicable legislative and regulatory requirements (see the relevant references and regulatory provisions on equivalence standards in Appendix I). To submit an application, you must provide the Ordre with the following documents: 1. This form, duly completed and signed; 2. A certified cheque or postal money order in the amount of Canadian $402.41 ($350 + GST and QST), payable to the“Ordre des optométristes du Québec,” for the examination of your application. (This amount is not reimbursable; however, $200 will be deducted from the professional dues for the first registration on the Membership Roll by a applicant who has been issued a permit to practice on the basis of a legal authorization to practice optometry elsewhere in Canada or in the United States); 3. For anyauthorization with respect to the practice of optometry in a jurisdiction outside Québec to which you refer in the form, a certificate of professional status in accordance with Appendix II, duly completed by the responsible regulatory authority and sent directly to the Order; 4. If you are not currently authorized to practice optometry elsewhere in Canada or in the United States, the following documents: a.For any diploma or program of studies to which you refer on this form, an academic record, or one or more documents published by an educational institution including a description of the courses taken with the number of related credits and the marks obtained; b. For any diploma or program of studies to which you refer within this form, the original or a copy certified as true by the issuinginstitution of the corresponding diploma or attestation of studies; c. For any training activity or any examination to which you refer on this form, an attestation of participation or success issued by the responsible agency; d. For any work experience to which you refer on this form, an attestation issued by the employer concerned. Other documents (such as an Évaluation comparative des équivalencesdes études effectuées hors du Québec [comparative evaluation of equivalence of studies performed outside Quebec] from the Ministère de l'Immigration et des Communautés culturelles du Québec may be requested from you at some time. You may also attach any other document you consider relevant. Any document listed above not written in French or English must be accompanied by a translation into French orEnglish attested by a declaration under oath by the person who did the translation. All documents submitted remain the property of the Order, except for the originals of diplomas, which will be returned to the applicant. The evaluation and processing of the application will be performed in accordance with applicable legislative and regulatory requirements, as a function of the informationprovided on this form and the related documents. This evaluation may also require you to participate in an interview, take an examination or complete a training period. If partial training equivalence is granted, you will be informed of what training
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2 program you must complete to obtain a full...