The following words and terms when used in this chapter shall have the following meanings unless the context clearly indicates otherwise:
"AAVSB" means the American Association of Veterinary State Boards.
"Animal shelter" means a facility, other than a
private residential dwelling and its surrounding grounds, that is used to house
or contain animals and that is owned, operated, or maintained by a
nongovernmental entity including, but not limited to, a humane society, animal
welfare organization, society for the prevention of cruelty to animals, or any
other organization operating for the purpose of finding permanent adoptive
homes for animals.
"Automatic emergency lighting" is lighting that is powered by battery, generator, or alternate power source other than electrical power, is activated automatically by electrical power failure, and provides sufficient light to complete surgery or to stabilize the animal until surgery can be continued or the animal moved to another establishment.
"AVMA" means the American Veterinary Medical Association.
"Board" means the Virginia Board of Veterinary Medicine.
"Companion animal" means any dog, cat, horse, nonhuman primate, guinea pig, hamster, rabbit not raised for human food or fiber, exotic or native animal, reptile, exotic or native bird, or any feral animal or animal under the care, custody or ownership of a person or any animal that is bought, sold, traded, or bartered by any person. Agricultural animals, game species, or any animals regulated under federal law as research animals shall not be considered companion animals for the purposes of this chapter.
"CVMA" means the Canadian Veterinary Medical Association.
"DEA" means the U.S. Drug Enforcement Administration.
"Full-service establishment" means a stationary
or ambulatory facility that provides surgery and encompasses all aspects of
health care for small or large animals, or both.
[ "ICVA" means the International Council for Veterinary Assessment. ]
and direct supervision" means that
the licensed veterinarian is immediately available to the licensed veterinary
technician or assistant, either electronically or in person, and provides a
specific order based on observation and diagnosis of the patient within the
last 36 hours.
"NBVME" means the National Board of
Veterinary Medical Examiners. ]
"Owner" means any person who (i) has a right of property in an animal; (ii) keeps or harbors an animal; (iii) has an animal in his care; or (iv) acts as a custodian of an animal.
"Pound" means a facility operated by the state or
a locality for the purpose of impounding or harboring seized, stray, homeless,
abandoned, or unwanted animals; or a facility operated for the same purpose
under a contract with a locality or an incorporated society for the prevention
of cruelty to animals.
"Preceptee" or "extern" means a student who is enrolled and in good standing in an AVMA accredited college of veterinary medicine or AVMA accredited veterinary technology program and who is receiving practical experience under the supervision of a licensed veterinarian or licensed veterinary technician.
"Preceptorship" or "externship" means a formal arrangement between an AVMA accredited college of veterinary medicine or an AVMA accredited veterinary technology program and a veterinarian who is licensed by the board and responsible for the practice of the preceptee. A preceptorship or externship shall be overseen by faculty of the college or program.
"Private animal shelter" means a facility that is used to house or contain animals and that is owned or operated by an incorporated, nonprofit, and nongovernmental entity, including a humane society, animal welfare organization, society for the prevention of cruelty to animals, or any other organization operating for the purpose of finding permanent adoptive homes for animals.
"Professional judgment" includes any decision or conduct in the practice of veterinary medicine, as defined by § 54.1-3800 of the Code of Virginia.
"Public animal shelter" means a facility operated by the Commonwealth, or any locality, for the purpose of impounding or sheltering seized, stray, homeless, abandoned, unwanted, or surrendered animals, or a facility operated for the same purpose under a contract with any locality.
"Restricted service establishment" means a
stationary or ambulatory facility which does not meet the requirements of a
"Specialist" means a veterinarian who has been
awarded and has maintained the status of diplomate of a specialty organization
recognized by the American Board of Veterinary Specialties of the American
Veterinary Medical Association, or any other organization approved by the
"Surgery" means treatment through revision, destruction, incision or other structural alteration of animal tissue. Surgery does not include dental extractions of single-rooted teeth or skin closures performed by a licensed veterinary technician upon a diagnosis and pursuant to direct orders from a veterinarian.
"Veterinarian in charge" "Veterinarian-in-charge" ]
means a veterinarian who holds an active license in Virginia and who is
responsible for maintaining a veterinary establishment within the standards set
by this chapter, for complying with federal and state laws and regulations, and
for notifying the board of the establishment's closure.
"Veterinary establishment" [ or
"establishment" ] means any
or mobile ambulatory practice, veterinary hospital, animal
hospital, or premises wherein or out of which veterinary medicine is
"Veterinary technician" means a person licensed by the board as required by § 54.1-3805 of the Code of Virginia.
18VAC150-20-30. Posting of licenses; accuracy of address.
A. All licenses
, and registrations and
permits issued by the board shall be posted in a place conspicuous to the
public at the establishment where veterinary services are being provided or available
for inspection at the location where an equine dental technician is working.
Licensees who do relief or temporary work in an establishment shall carry a
license with them or post it at the establishment. Ambulatory veterinary
practices that do not have an office accessible to the public shall carry their
licenses and permits registrations in their vehicles.
B. It shall be the duty and responsibility of each licensee,
registrant, and holder of a registration
permit to operate a
veterinary establishment to keep the board apprised at all times of his current
address of record and the public address, if different from the address of
record. All notices required by law or by this chapter to be mailed to any
veterinarian, veterinary technician, registered equine dental technician,
or holder of a permit registration to operate a veterinary
establishment , shall be validly given when mailed to the address of
record furnished to the board pursuant to this regulation. All address changes
shall be furnished to the board within 30 days of such change.
18VAC150-20-70. Licensure renewal requirements.
A. Every person licensed by the board shall, by January 1 of
every year, submit to the board a completed renewal application and pay to the
board a renewal fee as prescribed in 18VAC150-20-100. Failure to renew shall
cause the license to lapse and become invalid, and practice with a lapsed
license may subject the
licensees licensee to disciplinary action
by the board. Failure to receive a renewal notice does not relieve the licensee
of his responsibility to renew and maintain a current license.
B. Veterinarians shall be required to have completed a minimum of 15 hours, and veterinary technicians shall be required to have completed a minimum of eight hours, of approved continuing education for each annual renewal of licensure. Continuing education credits or hours may not be transferred or credited to another year.
1. Approved continuing education credit shall be given for courses or programs related to the treatment and care of patients and shall be clinical courses in veterinary medicine or veterinary technology or courses that enhance patient safety, such as medical recordkeeping or compliance with requirements of the Occupational Health and Safety Administration (OSHA).
2. An approved continuing education course or program shall be sponsored by one of the following:
a. The AVMA or its constituent and component/branch associations, specialty organizations, and board certified specialists in good standing within their specialty board;
b. Colleges of veterinary medicine approved by the AVMA Council on Education;
c. International, national, or regional conferences of veterinary medicine;
d. Academies or species-specific interest groups of veterinary medicine;
e. State associations of veterinary technicians;
f. North American Veterinary Technicians Association;
g. Community colleges with an approved program in veterinary technology;
h. State or federal government agencies;
i. American Animal Hospital Association (AAHA) or its constituent and component/branch associations;
j. Journals or veterinary information networks recognized by the board as providing education in veterinary medicine or veterinary technology; or
k. An organization or entity approved by the Registry of
Approved Continuing Education of the
American Association of Veterinary
State Boards AAVSB.
3. A licensee is exempt from completing continuing education requirements and considered in compliance on the first renewal date following his initial licensure by examination.
4. The board may grant an exemption for all or part of the continuing education requirements due to circumstances beyond the control of the licensee, such as temporary disability, mandatory military service, or officially declared disasters.
5. The board may grant an extension for good cause of up to one year for the completion of continuing education requirements upon written request from the licensee prior to the renewal date. Such an extension shall not relieve the licensee of the continuing education requirement.
6. Licensees are required to attest to compliance with
continuing education requirements on their annual license renewal and are
required to maintain original documents verifying the date and subject of the
program or course, the number of continuing education hours or credits, and
certification from an approved sponsor. Original documents must be maintained
for a period of two years following renewal. The board shall periodically
conduct a random audit to determine compliance. Practitioners selected for the
audit shall provide all supporting documentation within
days of receiving notification of the audit unless an extension is granted
by the board.
7. Continuing education hours required by disciplinary order shall not be used to satisfy renewal requirements.
8. Up to two hours of the 15 hours required for annual renewal of a veterinarian license and up to one hour of the eight hours required for annual renewal of a veterinary technician license may be satisfied through delivery of veterinary services, without compensation, to low-income individuals receiving health services through a local health department or a free clinic organized in whole or primarily for the delivery of those services. One hour of continuing education may be credited for three hours of providing such volunteer services, as documented by the health department or free clinic.
8. 9. ] Falsifying the
attestation of compliance with continuing education on a renewal form or
failure to comply with continuing education requirements may subject a licensee
to disciplinary action by the board, consistent with § 54.1-3807 of the Code of
C. A licensee who has requested that his license be placed on inactive status is not authorized to perform acts that are considered the practice of veterinary medicine or veterinary technology and, therefore, shall not be required to have continuing education for annual renewal. To reactivate a license, the licensee is required to submit evidence of completion of continuing education hours as required by § 54.1-3805.2 of the Code of Virginia and this section equal to the number of years in which the license has not been active for a maximum of two years.
18VAC150-20-75. Expired license; reinstatement; practice with an expired or lapsed license not permitted.
A. A license may be renewed up to one year after the expiration date, provided a late fee as prescribed in 18VAC150-20-100 is paid in addition to the required renewal fee. A license shall automatically lapse if the licensee fails to renew by the expiration date. The practice of veterinary medicine without a current, active license is unlawful and may subject the licensee to disciplinary action by the board.
B. Reinstatement of licenses expired for more than one year shall be at the discretion of the board. To reinstate a license, the licensee shall pay the reinstatement fee as prescribed in 18VAC150-20-100 and submit evidence of completion of continuing education hours as required by § 54.1-3805.2 of the Code of Virginia and 18VAC150-20-70 equal to the number of years in which the license has been expired, for a maximum of two years. The board may require additional documentation of clinical competency and professional activities.
The following fees shall be in effect:
Veterinary application for licensure
Veterinary license renewal (active)
Veterinary license renewal (inactive)
Veterinary reinstatement of expired license
Veterinary license late renewal
Veterinarian reinstatement after disciplinary action
Veterinary technician application for licensure
Veterinary technician license renewal
Veterinary technician license renewal (inactive)
Veterinary technician license late renewal
Veterinary technician reinstatement of expired license
Veterinary technician reinstatement after disciplinary action
Equine dental technician initial registration
Equine dental technician registration renewal
Equine dental technician late renewal
Equine dental technician reinstatement
Initial veterinary establishment
Veterinary establishment renewal
Veterinary establishment late renewal
Veterinary establishment reinstatement
Veterinary establishment reinspection
Veterinary establishment -- change of location
Veterinary establishment -- change of veterinarian-in-charge
Duplicate wall certificate
Licensure verification to another jurisdiction
Licensure for Veterinarians and Veterinary Technicians
18VAC150-20-110. Requirements for licensure by examination as a veterinarian.
A. The applicant, in order to be licensed by the board to practice veterinary medicine, shall:
1. Have received a degree in veterinary medicine from a college
or school of veterinary medicine accredited by the AVMA
or have fulfilled
the requirements of the Educational Commission of Foreign Veterinary Graduates (ECFVG)
of the AVMA or any other substantially equivalent credentialing body as
determined by the board., as verified by an official transcript from the
applicant's college or school, indicating completion of the veterinary degree
[ . In lieu of a degree from an accredited college or school, an
applicant may submit verification that he has fulfilled the requirements of the
Educational Commission of Foreign Veterinary Graduates of the AVMA or the
Program for the Assessment of Veterinary Education Equivalence of the AAVSB or
any other substantially equivalent credentialing body as determined by the
board ]; and
2. Have passed the North American Veterinary License
Examination (since the fall of 2000) or the National Board Examination and the
Clinical Competency Test (prior to the fall of 2000) of the [
ICVA ] or any other substantially equivalent national examination
as approved by the board with a score acceptable to the board.
3. In lieu of a degree from an accredited college
or school, an applicant may submit verification that he has fulfilled the
requirements of the Educational Commission of Foreign Veterinary Graduates
(ECFVG) of the AVMA or the Program for the Assessment of Veterinary Education
Equivalence (PAVE) of the AAVSB or any other substantially equivalent
credentialing body as determined by the board. ] 2. File the following documents with the board: B.
All applicants shall also: a. A 1. Submit the application fee specified in
18VAC150-20-100 and a complete and notarized application on a form
obtained from the board; b. An official copy, indicating veterinary degree, of the
applicant's college or school transcript; c. Certification of a full and unrestricted 2.
Provide verification that any license to practice veterinary medicine by
each board from which the applicant holds a license. issued by a board
of veterinary medicine in another state or United States jurisdiction is in
good standing; 3. Pass the North American Veterinary License Examination or
the National Board Examination and the Clinical Competency Test approved by the
American Association of Veterinary State Boards or any other substantially
equivalent national examination as approved by the board with a score
acceptable to the board. 4. 3. Sign a statement attesting that the applicant
has read, understands, and will abide by the statutes and regulations governing
[ veterinary the ] practice [ of veterinary
medicine ] in Virginia .; and 5. 4. Have committed no acts which that
would constitute a violation of § 54.1-3807 of the Code of Virginia. B. C. If the application for licensure has not
been successfully completed within one year from the date of initial
submission, a new application and fee shall be required.
18VAC150-20-115. Requirements for licensure by examination as a veterinary technician.
A. The applicant, in order to be licensed by the board as a veterinary technician, shall:
1. Have received a degree in veterinary technology from a college or school accredited by the AVMA or the CVMA.
2. Have filed with the board the following documents:
a. A complete [
and notarized ] application
on a form obtained from the board;
b. An official copy, indicating a veterinary technology degree, of the applicant's college or school transcript; and
Certification Verification that the applicant
is in good standing by each board in another state or United States
jurisdiction from which the applicant holds a license, certification,
or registration to practice veterinary technology.
Pass a Have passed the Veterinary Technician
National Examination approved by the AAVSB or any other board-approved,
national board examination for veterinary technology with a score acceptable to
4. Sign a statement attesting that the applicant has read,
understands, and will abide by the statutes and regulations governing [
the ] practice [ of veterinary medicine ] in
[ 5. Have submitted the application fee specified in 18VAC150-20-100.
5. 6. ] Have committed no acts
that would constitute a violation of § 54.1-3807 of the Code of Virginia.
B. The application for licensure shall be valid for a period of one year after the date of initial submission, after which time a new application and fee shall be required.
18VAC150-20-120. Requirements for licensure by endorsement as a veterinarian.
A. The board may, in its discretion, grant a license by
endorsement to an applicant who is licensed to practice veterinary medicine in
another [ state, the District of Columbia, or possessions or
territories jurisdiction ] of the United States, provided that the
All licenses are in good standing. Holds at least
one current, unrestricted license in another jurisdiction of the United States
and is not a respondent in any pending or unresolved board action in any
The applicant has been Provides documentation of
having been regularly engaged in clinical practice for at least two of the
past four years immediately preceding application; and
The applicant has met all applicable requirements of
18VAC150-20-110, except foreign-trained veterinarians who have attained
specialty recognition by a board recognized by the AVMA are exempt from the
requirements of ECFVG or any other substantially equivalent credentialing body
as determined by the board. Provides documentation of completion of at
least 30 hours of continuing education requirements during the preceding four
4. [ Submits the application fee specified in 18VAC150-20-100 and a complete application on a form obtained from the board;
5. ] Signs a statement attesting that the
applicant has read, understands, and will abide by the statutes and regulations
veterinary the ] practice
[ of veterinary medicine ] in Virginia; and
5. 6. ] Has committed no
acts that would constitute a violation of § 54.1-3807 of the Code of Virginia. B. Provided that the applicant has met the requirements of
subsection A of this section, the board may, in its discretion, waive the
requirement that the applicant pass the national board exam or the clinical
competency test, or both.
18VAC150-20-121. Requirements for licensure by endorsement for veterinary technicians.
In its discretion, the board may grant a license by
endorsement to an applicant who is licensed, certified or registered to
practice as a veterinary technician in another [
state, the District of
Columbia, or possessions or territories jurisdiction ]
of the United States, provided that the applicant:
All licenses, certificates or registrations are in good
standing Holds at least one current and unrestricted license,
certification, or registration [ issued by the regulatory entity ]
in another jurisdiction of the United States and that he is not a respondent
in any pending or unresolved board action in any jurisdiction;
The applicant has been Provides documentation of
having been regularly engaged in clinical practice as a licensed,
certified, or registered veterinary technician for at least two of the past
four years immediately preceding application; and
The applicant has Has received a degree in
veterinary technology from a college or school accredited by the AVMA or the
CVMA or has passed a the Veterinary Technician National Examination
approved by the AAVSB or any other board-approved national board examination
for veterinary technology with a score acceptable to the board .;
4. Provides documentation of completion of at least
12 16 ] hours of continuing education
requirements during the preceding four years;
5. [ Submits the application fee specified in 18VAC150-20-100 and a complete application on a form obtained from the board;
6. ] Signs a statement attesting that the
applicant has read, understands, and will abide by the statutes and regulations
veterinary the ] practice
[ of veterinary medicine ] in Virginia; and
6. 7. ] Has committed no
acts that would constitute a violation of § 54.1-3807 of the Code of Virginia.
18VAC150-20-130. Requirements for practical training in a preceptorship or externship.
A. The practical training and employment of qualified students of veterinary medicine or veterinary technology shall be governed and controlled as follows:
1. A veterinary student who is
duly enrolled and in good
standing in a veterinary college or school accredited or approved by the AVMA
may be engaged in a preceptorship or externship. A veterinary preceptee or extern
may perform duties that constitute the practice of veterinary medicine for
which he has received adequate instruction by the college or school and only
under the on-premises supervision of a licensed veterinarian.
2. A veterinary technician student who is
and in good standing in a veterinary technology program accredited or approved
by the AVMA may be engaged in a preceptorship or externship. A veterinary
technician preceptee or extern may perform duties that constitute the practice
of veterinary technology for which he has received adequate instruction by the
program and only under the on-premises supervision of a licensed veterinarian
or licensed veterinary technician.
B. Whenever a veterinary preceptee or extern is performing
surgery on a patient, either assisted or unassisted, the supervising
veterinarian shall be in the operatory during the procedure. Prior to allowing
a preceptee or extern in veterinary medicine to perform surgery on a patient
unassisted by a licensed veterinarian, a licensed veterinarian shall receive
approval informed consent ] from the owner.
C. When there is a [ veterinary ] preceptee or extern practicing in the establishment, the supervising veterinarian shall disclose such practice to owners. The disclosure shall be by signage clearly visible to the public or by inclusion on an informed consent form.
D. A veterinarian or veterinary technician who supervises a preceptee or extern remains responsible for the care and treatment of the patient.
18VAC150-20-135. Voluntary practice by out-of-state practitioners.
Any veterinarian who seeks registration to practice on a voluntary basis under the auspices of a publicly supported all volunteer, nonprofit organization that sponsors the provision of health care to populations of underserved people shall:
1. File a complete application for registration on a form provided by the board at least five business days prior to engaging in such practice. An incomplete application will not be considered;
2. Provide a complete record of professional licensure in each state in which he has held a license and a copy of every current license;
3. Provide the name of the nonprofit organization, the dates and location of the voluntary provision of services;
4. Pay a registration fee of $10; and
5. Provide a
notarized statement from a representative
of the nonprofit organization attesting to its compliance with provisions of subdivision
4 of § 54.1-3801 of the Code of Virginia.
18VAC150-20-140. Unprofessional conduct.
Unprofessional conduct as referenced in subdivision 5 of § 54.1-3807 of the Code of Virginia shall include the following:
1. Representing conflicting interests except by express consent of all concerned given after a full disclosure of the facts. Acceptance of a fee from both the buyer and the seller is prima facie evidence of a conflict of interest.
2. Practicing veterinary medicine or equine dentistry where an unlicensed person has the authority to control the professional judgment of the licensed veterinarian or the equine dental technician.
3. Issuing a certificate of health unless he shall know of his own knowledge by actual inspection and appropriate tests of the animals that the animals meet the requirements for the issuance of such certificate on the day issued.
4. Revealing confidences gained in the course of providing veterinary services to a client, unless required by law or necessary to protect the health, safety, or welfare of other persons or animals.
5. Advertising in a manner
which that is false,
deceptive, or misleading or which that makes subjective claims of
6. Violating any state law, federal law, or board regulation pertaining to the practice of veterinary medicine, veterinary technology or equine dentistry.
7. Practicing veterinary medicine or as an equine dental technician in such a manner as to endanger the health and welfare of his patients or the public, or being unable to practice veterinary medicine or as an equine dental technician with reasonable skill and safety.
8. Performing surgery on animals in an unregistered veterinary
establishment or not in accordance with the establishment
or with accepted standards of practice.
9. Refusing the board or its agent the right to inspect an establishment at reasonable hours.
10. Allowing unlicensed persons to perform acts restricted to the practice of veterinary medicine, veterinary technology, or an equine dental technician including any invasive procedure on a patient or delegation of tasks to persons who are not properly trained or authorized to perform such tasks.
11. Failing to provide immediate
and direct supervision
to a licensed veterinary technician or an assistant in his employ.
12. Refusing to release a copy of a valid prescription upon
a client an owner, unless there are medical reasons
documented in the patient record and the veterinarian would not dispense the
medication from his own practice.
13. Misrepresenting or falsifying information on an application or renewal form.
14. Failing to report suspected animal cruelty to the appropriate authorities.
15. Failing to release a copy of patient records when requested by the owner; a law-enforcement entity; or a federal, state, or local health regulatory agency.
16. Committing an act constituting fraud, deceit, or
misrepresentation in dealing with the board or in the
veterinarian-owner-patient relationship, or with the public.
17. Representing oneself as a "specialist" without meeting the definition set forth in 18VAC150-20-10 or using the words "specialist" or "specialty" in the name of a veterinary establishment unless there is a veterinarian on staff who meets the definition of a "specialist."
18. Failure to submit evidence of correction resulting from a violation noted in an inspection or reported by another agency within 14 days, unless an extension is granted by the board.
18VAC150-20-172. Delegation of duties.
A. A licensed veterinarian may delegate the administration
(including by injection) of Schedule VI drugs to a properly trained assistant
under his immediate
and direct supervision. The prescribing veterinarian
has a specific duty and responsibility to determine that the assistant has had
adequate training to safely administer the drug in a manner prescribed.
B. Injections involving
chemotherapy drugs, subgingival scaling, [ intubation, ] or
the placement of intravenous catheters shall not be delegated to an assistant. An
assistant shall also not be delegated the induction of sedation or anesthesia
by any means. The monitoring of a sedated or anesthetized patient may be
delegated to an assistant, provided [ the patient is no longer
intubated and provided ] a veterinarian or licensed veterinary
technician remains on premises until the patient is fully recovered. B. Additional C. [ The following
tasks Tasks ] that may be delegated by a licensed veterinarian
to a properly trained assistant [ include ] but are not limited to
5. Assisting in radiology;
6. Setting up diagnostic tests;
7. [ Prepping a patient or equipment for surgery
and scrubbing in preparation for surgery ];
8. Dental polishing and scaling of teeth above the gum line (supragingival);
9. Drawing blood samples; or
10. Filling of Schedule VI prescriptions under the direction of a veterinarian licensed in Virginia.
C. D. A licensed veterinarian may delegate
duties electronically, verbally, or in writing to appropriate veterinary
personnel provided the veterinarian has physically examined the patient within
the previous 36 hours. D. E. Massage therapy or, physical
therapy, or laser therapy may be delegated by a veterinarian to persons
qualified by training and experience by an order from the veterinarian. E. F. The veterinarian remains responsible for
the duties being delegated and remains responsible for the health and safety of
18VAC150-20-173. Informed consent for surgery.
A. Before surgery is performed, informed consent shall be obtained from the owner and documented in the patient record. Veterinarians shall inform an owner of the risks, benefits, and alternatives of the recommended surgery that a reasonably prudent practitioner in similar practice in Virginia would tell an owner.
B. An exception to the requirement for consent prior to performance of surgery may be made in an emergency situation when a delay in obtaining consent would likely result in imminent harm to the patient.
C. If a veterinary [
student, ] preceptee
[ , ] or extern is to perform the surgery,
[ either assisted or unassisted, ] the informed consent shall
include that information. [ If the surgery is to be performed by a
preceptee or extern unassisted by the veterinarian, the written informed
consent shall specifically state that information. ]
18VAC150-20-180. Requirements to be registered as a veterinary establishment.
A. Every veterinary establishment shall apply for registration
on a form provided by the board [
and may be issued and submit the
application fee specified in 18VAC150-20-100. The board may issue ] a permit
registration as a full-service or restricted service stationary
or ambulatory establishment. Every veterinary establishment shall have a
veterinarian-in-charge registered with the board in order to operate.
1. Veterinary medicine may only be practiced out of a
registered establishment except in emergency situations or in limited
specialized practices as provided in 18VAC150-20-171. The injection of a
microchip for identification purposes shall only be performed in a veterinary
establishment, except personnel of public or private animal shelters
pounds may inject animals while in their possession.
Applications An application ] for permits
registration must be made to the board 45 days in advance of opening or
changing the location of the establishment or requesting a change in the
establishment category to a full-service establishment listed on
3. Any addition or renovation of a stationary establishment or an ambulatory establishment that involves changes to the structure or composition of a surgery room shall require reinspection by the board and payment of the required fee prior to use.
B. A veterinary establishment will be registered by the board when:
1. It is inspected by the board and is found to meet the standards set forth by 18VAC150-20-190 and 18VAC150-20-200 or 18VAC150-20-201 where applicable. If, during a new or routine inspection, violations or deficiencies are found necessitating a reinspection, the prescribed reinspection fee will be levied. Failure to pay the fee shall be deemed unprofessional conduct and, until paid, the establishment shall be deemed to be unregistered.
2. A veterinarian currently licensed by and in good standing
with the board is registered with the board in writing as
has paid ensures that the
establishment registration fee has been paid.
18VAC150-20-181. Requirements for veterinarian-in-charge.
A. The veterinarian-in-charge of a veterinary establishment is responsible for:
1. Regularly being on site
on a schedule of no less than
monthly and providing as necessary to provide routine oversight to
the veterinary establishment for patient safety and compliance with law and
2. Maintaining the facility within the standards set forth by this chapter.
3. Performing the biennial controlled substance inventory and ensuring compliance at the facility with any federal or state law relating to controlled substances as defined in § 54.1-3404 of the Code of Virginia. The performance of the biennial inventory may be delegated to another licensee, provided the veterinarian-in-charge signs the inventory and remains responsible for its content and accuracy.
4. Notifying the board in writing of the closure of the
registered facility 10 days prior to closure.
5. Notifying the board immediately if no longer acting as the veterinarian-in-charge.
6. Ensuring the establishment maintains a current and valid
registration issued by the board.
B. Upon any change in veterinarian-in-charge, these procedures shall be followed:
1. The veterinarian-in-charge registered with the board remains responsible for the establishment and the stock of controlled substances until a new veterinarian-in-charge is registered or for five days, whichever occurs sooner.
2. An application for a new
naming the new veterinarian-in-charge, shall be made five days prior to the
change of the veterinarian-in-charge. If no prior notice was given by the
previous veterinarian-in-charge, an application for a new permit registration
naming a new veterinarian-in-charge shall be filed as soon as possible,
but no more than 10 days, after the change.
3. The previous establishment
is void on the date of the change of veterinarian-in-charge and shall be
returned by the former veterinarian-in-charge to the board five days following
the date of change.
4. Prior to the opening of the business, on the date of the
change of veterinarian-in-charge, the new veterinarian-in-charge shall take a
complete inventory of all [
Schedule ] II-V
[ Schedules ] II through V drugs on hand. He shall date
and sign the inventory and maintain it on premises for two three
years. That inventory may be designated as the official biennial controlled
C. Prior to the sale or closure of a veterinary
involving the transfer of patient records to
another location ] the veterinarian-in-charge shall:
1. Follow the requirements for transfer of patient records [ to another location ] in accordance with § 54.1-2405 of the Code of Virginia; and
Provide If there is no transfer
of records upon sale or closure of an establishment, the veterinarian-in-charge
shall provide ] to the board information about the location of
[ or access to ] patient records and the disposition of all
18VAC150-20-185. Renewal of veterinary establishment
A. Every veterinary establishment shall be required to renew
permit by January 1 of each year and pay to the board a
registration fee as prescribed in 18VAC150-20-100.
B. Failure to renew the establishment
by January 1 of each year shall cause the permit registration to
expire and become invalid. Practicing veterinary medicine in an
establishment with an expired registration may subject a licensee or
registration holder to disciplinary action by the board. The permit registration
may be reinstated without reinspection within 30 days of expiration, provided
the board receives a properly executed renewal application, renewal fee, and a
late fee as prescribed in 18VAC150-20-100.
C. Reinstatement of an expired
after 30 days shall be at the discretion of the board and contingent upon a
reinspection and payment of the late fee, the reinspection fee, the renewal fee
and the veterinary establishment permit registration
18VAC150-20-190. Requirements for drug storage, dispensing,
destruction, and records for all establishments
, full service and restricted.
A. All drugs shall be maintained, administered, dispensed, prescribed and destroyed in compliance with state and federal laws, which include § 54.1-3303 of the Code of Virginia, the Drug Control Act (§ 54.1-3400 et seq. of the Code of Virginia), applicable parts of the federal Food, Drug, and Cosmetic Control Act (21 USC § 301 et seq.), the Prescription Drug Marketing Act (21 USC § 301 et seq.), and the Controlled Substances Act (21 USC § 801 et seq.), as well as applicable portions of Title 21 of the Code of Federal Regulations.
B. All repackaged tablets and capsules dispensed for companion
animals shall be in approved safety closure containers, except safety caps
shall not be required when any person who requests that the medication not have
a safety cap, or in such cases in which the medication is of such form or size
that it cannot be reasonably dispensed in such containers (e.g., topical
medications, ophthalmic, or otic).
A client An owner request for
nonsafety packaging shall be documented in the patient record.
C. All drugs dispensed for companion animals shall be labeled with the following:
1. Name and address of the facility;
Name First and last name of client owner;
3. Animal identification and species;
4. Date dispensed;
5. Directions for use;
6. Name, strength (if more than one dosage form exists), and quantity of the drug; and
7. Name of the prescribing veterinarian.
drugs shall be maintained veterinary
establishments shall maintain drugs in a secured secure
manner with precaution taken to prevent theft or diversion. Only the
veterinarian [ or licensed, ] veterinary
technician [ , pharmacist, or pharmacy technician ] shall
have access to [ Schedule Schedules ] II
through V drugs [ , with the exception provided in subdivision 6 of
this subsection ].
All Schedule II through V drugs shall be maintained under
lock at all times, with access to the veterinarian or veterinary technician
only, but not to any unlicensed personnel In a stationary establishment,
the general stock of [ Schedule Schedules ] II
through V drugs shall be stored in a securely locked cabinet or safe that is
not easily movable.
2. The establishment may also have a working stock of
Schedule Schedules ] II through V drugs
that shall be kept in (i) a securely locked container, cabinet, or safe when
not in use or (ii) direct possession of a veterinarian or veterinary
technician. A working stock shall consist of only those drugs that are
necessary for use during a normal business day or 24 hours, whichever is less.
3. Whenever the establishment is closed, all general and
working stock of [
Schedule Schedules ] II
through V drugs and any dispensed prescriptions that were not delivered during
normal business hours shall be securely stored as required for the general
4. Prescriptions that have been dispensed and prepared for delivery shall be maintained under lock or in an area that is not readily accessible to the public and may be delivered to an owner by an unlicensed person, as designated by the veterinarian.
2. 5. Whenever a veterinarian discovers a
theft or any unusual loss of [ Schedule Schedules ] II ,
III, IV, or through V drugs is discovered, he the
veterinarian-in-charge, or in his absence, his designee, shall immediately
report such theft or loss to the Board of Veterinary Medicine and the Board
of Pharmacy and to the U.S. Drug Enforcement Administration DEA.
The report to the boards shall be in writing and sent electronically or by
regular mail. The report to the DEA shall be in accordance with 21 CFR 1301.76(b).
If the veterinarian-in-charge is unable to determine the exact kind and
quantity of the drug loss, he shall immediately take a complete inventory of
all [ Schedule Schedules ] II through V
[ 6. Access to drugs by unlicensed persons shall be allowed only under the following conditions:
a. An animal is being kept at the establishment outside of the normal hours of operation, and a licensed practitioner is not present in the facility;
b. The drugs are limited to those dispensed to a specific patient; and
c. The drugs are maintained separately from the establishment's general drug stock and kept in such a manner so they are not readily available to the public. ]
Schedule Schedules ] II , III,
IV and through V drugs shall be destroyed by (i) transferring the
drugs to another entity authorized to possess or provide for proper disposal of
such drugs or (ii) destroying the drugs by burning in an incinerator that is
in compliance with applicable local, state, and federal laws and regulations.
If [ Schedule Schedules ] II through V drugs are to be
destroyed, a DEA drug destruction form shall be fully completed and used as the
record of all drugs to be destroyed. A copy of the destruction form shall be
retained at the veterinarian practice site with other inventory records.
F. The drug storage area shall have appropriate provision for
temperature control for all drugs and biologics
, including. If drugs
requiring refrigeration are maintained at the facility, they shall be kept in
a refrigerator with the interior thermometer maintained between 36°F and 46°F. If
a refrigerated drug is in [ Schedule Schedules ]
II through V, the drug shall be kept in a locked container secured to the
refrigerator, or the refrigerator shall be locked. Drugs stored at room
temperature shall be maintained between 59°F and 86°F.
G. The stock of drugs shall be reviewed frequently, and expired drugs shall be removed from the working stock of drugs at the expiration date and shall not be administered or dispensed.
G. H. A distribution record shall be maintained
in addition to the patient's record, in chronological order, for the
administration and dispensing of all [ Schedule ] II-V
[ Schedules ] II through V drugs.
This record is to be maintained for a period of
years from the date of transaction. This record shall include the following:
1. Date of transaction;
2. Drug name, strength, and the amount dispensed, administered, and wasted;
Client Owner and animal identification; and
4. Identification of the veterinarian authorizing the administration or dispensing of the drug.
H. I. Original invoices for all [ Schedule
Schedules ] II , III, IV and through V drugs received
shall be maintained in chronological order on the premises where the stock of
drugs is held, and the actual date of receipt is shall
be noted. Invoices for Schedule II drugs shall be maintained separately
from other records. All drug records shall be maintained for a period of two
three years from the date of transaction. I. J. A complete and accurate inventory of all
[ Schedule Schedules ] II , III, IV and through
V drugs shall be taken, dated, and signed on any date that is within two years
of the previous biennial inventory. Drug strength must be specified. This inventory
shall indicate if it was made at the opening or closing of business and shall
be maintained on the premises where the drugs are held for two three
years from the date of taking the inventory.
K. Inventories and records, including original invoices, of Schedule II drugs shall be maintained separately from all other records, and the establishment shall maintain a continuous inventory of all Schedule II drugs received, administered, or dispensed, with reconciliation at least monthly. Reconciliation requires an explanation noted on the inventory for any difference between the actual physical count and the theoretical count indicated by the distribution record. A continuous inventory shall accurately indicate the physical count of each Schedule II drug in the general and working stocks at the time of performing the inventory.
J. L. Veterinary establishments in which bulk
reconstitution of injectable, bulk compounding, or the prepackaging of
drugs is performed shall maintain adequate control records for a period of one
year or until the expiration, whichever is greater. The records shall show the
name of the drug(s) drugs used; strength, if any; date
repackaged; quantity prepared; initials of the veterinarian verifying the
process; the assigned lot or control number; the manufacturer's or
distributor's name and lot or control number; and an expiration date.
M. If a limited stationary or ambulatory practice uses the
facilities of another veterinary establishment, the drug distribution log shall
clearly reveal whose [
Schedule Schedules ] II
through V drugs were used. If the establishment's drug stock is used, the
distribution record shall show that the procedure was performed by a visiting
veterinarian who has the patient record. If the visiting veterinarian uses his
own stock of drugs, he shall make entries in his own distribution record and in
the patient record and shall leave a copy of the patient record at the other
A. A legible, daily record of each patient treated
shall be maintained by the veterinarian at the [
permitted registered ]
veterinary establishment and shall include pertinent medical data such as
drugs administered, dispensed or prescribed, and all relevant medical and
surgical procedures performed. Records should contain at a minimum:
1. Name of the patient and the owner;
2. Identification of the treating veterinarian and of the person making the entry (Initials may be used if a master list that identifies the initials is maintained.);
1. 3. Presenting [ complaint/reason complaint
or reason ] for contact;
4. Date of contact;
2. 5. Physical examination findings , if
appropriate; 3. 6. Tests and diagnostics performed and
results; 4. 7. Procedures [ performed/treatment
performed, treatment ] given [ , ] and
results; and 5. 8. Drugs (and their dosages)
administered, dispensed, or prescribed, including quantity, strength
and dosage, and route of administration. For vaccines, identification of
the lot and manufacturer shall be maintained;
9. Radiographs or digital images clearly labeled with identification of the establishment, the patient name, date taken, and anatomic specificity. If an original radiograph or digital image is transferred to another establishment or released to the owner, a record of this transfer or release shall be maintained on or with the patient's records; and
10. Any specific instructions for discharge or referrals to other practitioners.
Individual records An individual record shall
be maintained on each patient, except that records for economic animals or
litters of companion animals under the age of four months may be maintained on
a per client owner basis. Client Patient records,
including radiographs or digital images, shall be kept for a period of
three years following the last office visit or discharge of such animal from a
veterinary establishment. C. An animal identification system must be used by the
establishment. D. Upon the sale or closure of a veterinary establishment
involving the transfer of patient records to another location, the veterinarian
shall follow the requirements for transfer of patient records in accordance
with § 54.1-2405 of the Code of Virginia. E. C. An initial rabies certification for an
animal receiving a primary rabies vaccination shall clearly display the
following information: "An animal is not considered immunized for at least
28 days after the initial or primary vaccination is administered."
18VAC150-20-200. Standards for stationary veterinary establishments.
Full-service Stationary establishments. A full-service
stationary establishment shall provide surgery and encompass all aspects
of health care for small or large animals, or both. All full-service stationary
establishments shall meet the requirements set forth below in this
1. Buildings and grounds must be maintained to provide sanitary facilities for the care and medical well-being of patients.
a. Temperature, ventilation, and lighting must be consistent with the medical well-being of the patients.
Water and waste. There shall be on-premises:
(1) Hot and cold running water of drinking quality, as defined by the Virginia Department of Health;
(2) An acceptable method of disposal of deceased animals, in accordance with any local ordinance or state and federal regulations; and
(3) Refrigeration exclusively for carcasses of companion animals that require storage for 24 hours or more.
c. Sanitary toilet and lavatory shall be available for
2. Areas within building. The areas within the facility shall include the following:
a. A reception area separate from other designated rooms;
b. Examination room or rooms containing a table or tables with nonporous surfaces;
Surgery room. There shall be a A room which
that is reserved only for surgery and used for no other purpose. The
walls of the surgery room must be constructed of nonporous material and extend
from the floor to the ceiling. In order that surgery can be performed in a
manner compatible with current veterinary medical practice with regard to
anesthesia, asepsis, life support, and monitoring procedures, the surgery room
(1) Have walls constructed of nonporous material and extending from the floor to the ceiling;
(2) Be of a size adequate to accommodate a surgical
table, anesthesia support equipment, surgical supplies,
the veterinarian, an
assistant, and the patient and all personnel necessary for safe
performance of the surgery; (2) (3) Be kept so that storage in the surgery
room shall be limited to items and equipment normally related to surgery and
(4) Have a surgical table made of nonporous material;
(5) Have surgical supplies, instruments, and equipment commensurate with the kind of services provided;
(6) Have surgical and automatic emergency lighting to facilitate performance of procedures; and
(3) (7) For small animal facilities establishments
that perform surgery on small animals, have a door to close off the surgery
room from other areas of the practice. d. Laboratory. 3. The veterinary establishment
shall have, as at a minimum, proof of use of either in-house
laboratory service or outside laboratory services for performing the
following lab tests, consistent with appropriate professional care for the
species being treated :. (1) Urinalysis, including microscopic examination of
sediment; (2) Complete blood count, including differential; (3) Flotation test for ova of internal parasites; (4) Skin scrapings for diagnosing external parasites; (5) Blood chemistries; (6) Cultures and sensitivities; (7) Biopsy; (8) Complete necropses, including histopathology; and (9) Serology. e. Animal housing areas. These shall be provided with 4.
For housing animals, the establishment shall provide:
a. An animal identification system at all times when housing an animal;
b. Accommodations of appropriate size and construction to prevent residual contamination or injury;
(1) Separate compartments constructed in such a way as to
prevent residual contamination; (2) c. Accommodations allowing for the effective
separation of contagious and noncontagious patients; and (3) d. Exercise runs which areas that
provide and allow effective separation of animals or walking the animals at
medically appropriate intervals. 3. Radiology. 5. A veterinary establishment shall :
a. Either either have radiology service in-house or documentation of
outside services for obtaining diagnostic-quality radiographs. b. If
radiology is in-house : (1) Each radiograph shall be permanently imprinted
with the identity of the facility or veterinarian, patient and the date of
exposure. Each radiograph shall also be clearly labeled by permanent imprinting
to reflect anatomic specificity. (2) Document, the establishment shall:
a. Document that radiographic equipment complies with Part VI (12VAC5-481-1581 et seq.), Use of Diagnostic X-Rays in the Healing Arts, of the Virginia Radiation Protection Regulations of the Virginia Department of Health, which requirements are adopted by this board and incorporated herewith by reference in this chapter.
c. Maintain radiographs as a part of the patient's record.
If a radiograph is transferred to another establishment or released to the
client, a record of this transfer must be maintained on or with the patient's
b. Maintain and utilize lead aprons and gloves and individual radiation exposure badges for each employee exposed to radiographs.
4. Equipment; minimum requirements. 6. Minimum
equipment in the establishment shall include: a. Examination room containing a table with nonporous
surface. b. Surgery suite. (1) Surgical table with nonporous surface; (2) Surgical supplies, instruments and equipment
commensurate with the kind of surgical services provided; (3) Automatic emergency lighting; (4) Surgical lighting; (5) Instrument table, stand, or tray; and (6) Waste receptacle. c. Radiology (if in-house). (1) Lead aprons and gloves; (2) Radiation exposure badges; and (3) X-ray machine. d. General equipment. (1) Steam pressure sterilizer or an a. An
appropriate method of sterilizing instruments; (2) b. Internal and external sterilization
monitors , if steam pressure sterilizers are used; (3) c. Stethoscope; (4) Thermometer; (5) d. Equipment for delivery of assisted
ventilation appropriate to the species being treated, including but
not necessarily limited to: (a) A resuscitation bag; and (b) Endotracheal endotracheal
tubes .; (6) Scales e. Adequate means of determining
patient's weight; and (7) f. Storage for records.
B. Additional requirements for stationary establishments.
1. A stationary establishment that is open to the public 24 hours a day shall have licensed personnel on premises at all times and shall be equipped to handle emergency critical care and hospitalization. The establishment shall have radiology/imaging and laboratory services available on site.
2. A stationary establishment that is not open to the public 24 hours a day shall have licensed personnel available during its advertised hours of operation and shall disclose to the public that the establishment does not have continuous staffing in compliance with § 54.1-3806.1 of the Code of Virginia.
3. All stationary establishments shall provide for continuity of care when a patient is transferred to another establishment.
Restricted C. Limited stationary establishments.
When the scope of practice is less than full service, a specifically restricted
limited establishment permit registration shall be
required. Upon submission of a completed application, satisfactory inspection,
and payment of the permit [ veterinary establishment ] registration
fee, a restricted limited establishment permit registration
may be issued. Such restricted establishments shall have posted in a
conspicuous manner the specific limitations on the scope of practice on a form
provided by the board. 1. Large animal establishment, ambulatory practice. A large
animal ambulatory establishment is a mobile practice in which health care of
large animals is performed at the location of the animal. Surgery on large
animals may be performed as part of a large animal ambulatory practice provided
the facility has surgical supplies, instruments and equipment commensurate with
the kind of surgical services provided. All large animal ambulatory
establishments shall meet the requirements of a full-service establishment in
subsection A of this section with the exception of those set forth below: a. All requirements for buildings and grounds. b. All requirements for an examination room and surgery
suite. c. Equipment for assisted ventilation. d. Scales. 2. Small animal establishment, house call practice. A small
animal house call establishment is a mobile practice in which health care of
small animals is performed at the residence of the owner of the small animal.
Surgery may be performed only in a surgical suite that has passed inspection.
Small animal house call facilities shall meet the requirements of a
full-service establishment in subsection A of this section with the exception
of those set forth below: a. All requirements for buildings and grounds. b. All requirements for an examination room or surgery
suite. c. Steam pressure sterilizer. d. Internal or external sterilization monitor. 3. Small animal establishment, outpatient practice. A small
animal outpatient establishment is a stationary facility or ambulatory practice
where health care of small animals is performed. This practice may include
surgery, provided the facility is equipped with a surgery suite as required by
subdivision A 2 c of this section. Overnight hospitalization shall not be
required. All other requirements of a full-service establishment shall be met. C. D. A separate [ facility permit establishment ]
registration is required for separate practices that share the same
18VAC150-20-201. Standards for ambulatory veterinary establishments.
A. Agricultural or equine ambulatory practice. An agricultural or equine ambulatory establishment is a mobile practice in which health care is performed at the location of the animal. Surgery on large animals may be performed as part of an agricultural or equine ambulatory practice provided the establishment has surgical supplies, instruments, and equipment commensurate with the kind of surgical procedures performed. All agricultural or equine ambulatory establishments shall meet the requirements of a stationary establishment for laboratory, radiology, and minimum equipment, with the exception of equipment for assisted ventilation.
B. House call or proceduralist establishment. A house call or proceduralist establishment is an ambulatory practice in which health care of small animals is performed at the residence of the owner of the small animal or another establishment registered by the board. A veterinarian who has established a veterinarian-owner-patient relationship with an animal at the owner's residence or at another registered veterinary establishment may also provide care for that animal at the location of the patient.
1. Surgery may be performed only in a surgical suite at a registered establishment that has passed inspection. [ However, surgery requiring only local anesthetics may be performed at a location other than in a surgical suite. ]
2. House call or proceduralist establishments shall meet the requirements of a stationary establishment for laboratory, radiology, and minimum equipment, with the exception of equipment for assisted ventilation.
C. Mobile service establishment. A mobile service establishment is a veterinary clinic or hospital that can be moved from one location to another and from which veterinary services are provided. A mobile service establishment shall meet all the requirements of a stationary establishment appropriate for the services provided.
D. A separate establishment registration is required for separate practices that share the same location.
18VAC150-20-210. Revocation or suspension of a veterinary
permit registration. A. The board may revoke or suspend or take other
disciplinary action deemed appropriate against the registration permit
of a veterinary establishment if it finds the establishment to be in violation
of any provisions provision of laws or regulations governing
veterinary medicine or if:
1. The board or its agents are denied access to the establishment to conduct an inspection or investigation;
licensee holder of a registration does not
pay any and all prescribed fees or monetary penalties;
3. The establishment is performing procedures beyond the scope
restricted limited [ stationary ]
establishment permit registration; or
4. The establishment has no veterinarian-in-charge registered with the board.
B. The Administrative Process Act (§ 2.2-4000 et seq. of
the Code of Virginia) shall apply to any determination under this section.
Equine Dental Technicians
18VAC150-20-220. Requirements for registration as an equine dental technician.
A. A person applying for registration as an equine dental technician shall provide a recommendation from at least two veterinarians licensed in Virginia who attest that at least 50% of their practice is equine, and that they have observed the applicant within the past five years immediately preceding the attestation and can attest to his competency to be registered as an equine dental technician.
B. The qualifications for registration shall include documentation of one of the following:
1. Current certification from the International Association of Equine Dentistry;
2. Completion of a board-approved certification program or training program;
3. Completion of a veterinary technician program that includes equine dentistry in the curriculum; or
4. Evidence of equine dental practice for at least five years and proof of 16 hours of continuing education in equine dentistry completed within the five years immediately preceding application for registration.
C. In order to maintain an equine dental technician registration, a person shall renew such registration by January 1 of each year by payment of the renewal fee specified in 18VAC150-20-100 and attestation of obtaining 16 hours of continuing education relating to equine dentistry within the past three years.
1. Equine dental technicians shall be required to maintain
original documents verifying the date and subject of the continuing education program
or course, the number of continuing education hours, and certification of
completion from a sponsor. Original documents shall be maintained for a period
of two years following renewal. The board shall periodically conduct a random
audit to determine compliance. Practitioners selected for the audit shall
provide all supporting documentation within
10 14 days of
receiving notification of the audit, unless granted an extension by the
a. The board may grant an exemption for all or part of the continuing education requirements due to circumstances beyond the control of the technician, such as temporary disability, mandatory military service, or officially declared disasters.
b. The board may grant an extension for good cause of up to one year for the completion of continuing education requirements upon written request from the technician prior to the renewal date. Such an extension shall not relieve the technician of the continuing education requirement.
2. Registration may be renewed up to one year after the expiration date, provided a late fee as prescribed in 18VAC150-20-100 is paid in addition to the required renewal fee.
3. Reinstatement of registration expired for more than one year shall be at the discretion of the board. To reinstate a registration, the applicant shall pay the reinstatement fee as prescribed in 18VAC150-20-100 and submit evidence of completion of continuing education hours equal to the number of years in which the registration has been expired, for a maximum of two years. The board may require additional documentation of clinical competency and professional activities.