NOTE: Your application will not be processed if the appropriate section below is not completed. See the Criteria handbook for further explanation of the eligibility criteria. Supporting documentation of your education (such as a transcript or a copy of a certificate of completion) must be attached.
Download Credits form
Download OSA log form
Download CDOS form
IJCAHPO's Responsibility for Certification and Recertification of Medical Personnel Performing Technical Ophthalmic Services for Ophthalmologists
IJCAHPO is the federated organization of ophthalmological societies and associations which has been charged with certain responsibilities related to the education and utilization of allied health personnel in ophthalmology. To implement these goals, IJCAHPO has established criteria for training, examination, certification, and utilization at various levels of expertise for ophthalmic medical personnel.
Certification by IJCAHPO indicates ONLY that the individual has fulfilled the eligibility requirements and successfully completed an examination for which the individual qualifies. Certification by IJCAHPO does NOT imply, by any criteria, that the individual is qualified as an independent practitioner.
AGREEMENT OF CERTIFICATION AND RECERTIFICATION
As an applicant for certification or recertification from IJCAHPO, I agree to the following:
Numbers 1 and 2 applicable to COA, COT, COMT, OSA, CDOS, and ROUB applicants only
1. I shall perform, to the best of my ability, those technical ophthalmic services specifically delegated to me by a sponsoring ophthalmologist/physician according to his or her directions, instructions, and prescriptions.
2. I shall provide technical ophthalmic services only in the office of my sponsoring ophthalmologist/physician, a medical clinic, or other medical facility.
Number 3 applicable to CCOA applicants only
3. I am currently employed by a corporation that does business within the ophthalmic community and, in my position, I will be interacting with ophthalmic professionals on a continuing basis.
Numbers 4-10 applicable to all applicants
4. I authorize IJCAHPO to communicate any violation of its rules or standards by me, my status of application or certification, and any matter involving me to state and federal authorities, employers, training programs, and others.
5. I agree not to make and to correct immediately any statements concerning my certification status which are or which become untrue or misleading. I agree to provide IJCAHPO confirmation as requested by IJCAHPO.
6. I release IJCAHPO, its officers, directors, agents, employers, committee members, and others for disciplinary action taken in good faith pursuant to the rules, standards, procedures, and sanctions of IJCAHPO.
7. I authorize IJCAHPO in its discretion to request information concerning matters relevant to this application and my certification, recertification, and review of certification.
8. I have received and read the rules, standards, procedures and sanctions of IJCAHPO. I comply with and agree to be bound by them.
If you marked yes to any of the questions in number 9, please include a statement of explanation and a copy of verification to show any penalties have been completed.
10. IJCAHPO examinations are confidential and proprietary. The examination(s) are available to you, the examinee, soley for the purpose of assessing your proficiency level in the content areas referenced in the examination(s) for which you are eligible. You are expressly prohibited from disclosing, publishing, reproducing, or transmitting the examination(s) in any matter, in whole or in part, in any form or by any means, verbal or written, electronic or mechanical, for any purpose. By signing this application you agree to the above disclosure statement. If you do not agree to the disclosure statement and do not sign the application you will not be eligible to take any IJCAHPO examinations.
I affirm that all statements made in the above application are true.
Release of Examination Data
IJCAHPO reserves the right to use, for any purpose, all examination data in aggregate reports related to exam performance. Release of such data will not include names or personal, identifiable information. Examples of the purposed, for which such data might be used include, but are not limited to: IJCAHPO research projects, grants, and formal training program reports.
Information regarding whether or not you are actively certified is public and may be verified or accessed by anyone.
If you wish to authorize IJCAHPO’s release of your individual, identifiable data (name) to any source, please contact IJCAHPO, in writing, with the name of the intended recipient and the time period in which release can be made.
Compliance with the Americans with Disabilities Act (ADA)
In compliance with the ADA, IJCAHPO will provide reasonable accommodations for candidates with disabilities who cannot take the examination under the usual testing conditions. Disabled individuals must provide notice and appropriate documentation (at the applicant’s expense) of their disability when applying for the examination.
If accommodations are necessary for you to complete a IJCAHPO examination due to functional limitations imposed by a disability, you will be required to complete and return a questionnaire. Questionnaires must be submitted with proper documentation and included with the examination application.