Forms & Links

Practitioners

Forms & Links

DVM Forms

Licensure Application for Veterinarians	241 KB
Licensure Application for Veterinary Telehealth Practitioner	242 KB
Veterinary License Applicant Checklist	199 KB
Criminal Background Check Instructions - Online	136 KB
Criminal Background Check Instructions - Manual Fingerprint	301 KB
NAVLE Application	190 KB
Renewal for Veterinarians	334 KB
Renewal for Veterinary Telehealth Practititioners	246 KB
Inactive Application License Checklist	110 KB
Inactive/Expired License Reactivation for Veterinarians Renewal Form	188 KB
Reactivation of Expired Veterinary License Checklist	134 KB
Veterinarian Continuing Education Guidelines	109 KB
Petition for Determination of Initial License	115 KB
Military Family Waiver	141 KB
AVMA List of Specialties	128 KB
CE Hardship Extension Request	45 KB
WV Verification Request Form	47 KB
Name & Address Change	115 KB
Reportable Diseases	22 KB
Practice Act - Effective March 1, 2023	1574 KB
Chapter 30-10 Code	218 KB
Certification of Copy	51 KB
CE Approval Request	81 KB
DEA Initial Inventory Template	51 KB
DEA Biennial Inventory Template	51 KB
Waiver of Initial License	102 KB
Temporary Emergency License	158 KB
Controlled Substance & Opioid Questions/Answers	118 KB
Application for Volunteer License	203 KB

CAET Forms

Chapter 30-10 Code	218 KB
CAET Application	219 KB
CAET Application Checklist	192 KB
CAET Continuing Education Guidelines	48 KB
CAET Renewal	214 KB
CE Hardship Extension Request	45 KB
Name & Address Change	115 KB
CE Approval Request	81 KB
Animal Euthanasia Annual Total Report	130 KB
CAET New Approved Sedative Drug Handout	110 KB
Criminal Background Check Instructions - Online	136 KB
Dexdomitor Canine Dosing Chart	133 KB
Dexdomitor Feline Dosing Chart	482 KB
DEA Initial Inventory Template	51 KB
DEA Biennial Inventory Template	51 KB
Certification of Copy	51 KB
Practice Act - Effective March 1, 2023	1574 KB
Petition of Determination of Initial License	115 KB
Waiver of Initial License	102 KB
Military Family Waiver	141 KB

RVT Forms

Chapter 30-10 Code	218 KB
RVT Application	256 KB
RVT Application Checklist	202 KB
RVT CE Guidelines	104 KB
RVT Renewal	214 KB
RVT Reactivation Checklist	189 KB
WV Verification Request Form	47 KB
CE Hardship Extension Request	45 KB
CE Approval Request	81 KB
Name & Address Change	115 KB
Temporary Emergency Registration	158 KB
Practice Act - Effective March 1, 2023	1574 KB
Certification of Copy	51 KB
Petition of Determination of Initial License	115 KB
Reactivation of Expired Veterinary Technician Registration Checklist	189 KB
Criminal Background Check Instructions - Online	136 KB
Criminal Background Check Instructions - Manual Fingerprint	301 KB
Waiver of Initial License	102 KB
Military Family Waiver	141 KB

Facility

Abandoned Animal	77 KB
Ambulatory Inspection Breakdown	135 KB
Ambulatory Inspection Form	109 KB
Ambulatory Inspection Policy	435 KB
Animal Euthanasia Facility Opened Container Log	314 KB
Animal Euthanasia Facility Unopened Container Log	311 KB
Animal Euthanasia Inspection Form	130 KB
Animal Euthanasia Registration and Renewal	104 KB
CAET Controlled Substance Register	93 KB
CAET Sedative Ordering	150 KB
Controlled Substance Register	97 KB
DEA Biennial Inventory Template	51 KB
DEA Initial Inventory Template	51 KB
DEA Registered Reverse Distributors	167 KB
DEA Requirements	220 KB
DEA Reverse Distributor - Mail In	98 KB
Facility Registration and Renewal	116 KB
Label Requirements	72 KB
Military Inspection Fee Waiver	92 KB
Patient Medical Record Inspection Guidance	108 KB
Patient Record Template – Minimum Requirements	67 KB
Radiation Machine Registration Form	396 KB
Radiology Health Program	116 KB
Stationary/Mobile Inspection Guidelines	127 KB
Veterinary Facility Inspection Form	151 KB

Helpful Links

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Quick Links

WV Board of Veterinary Medicine
5509 Big Tyler Rd, Ste 3
Cross Lanes, WV 25313
Phone: 304-776-8032
Email: Contact Us

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