Request for Materials

The following materials are available upon request:

  • Form for Filing a Complaint Against a Podiatrist
  • Application for Additional Privileges - (requires TWO copies of completed application form, and TWO copies of surgery LOGS, HIGHLIGHTED with different colors for Ankle Surgery, Amputations, and/or Club Foot procedures)
  • Request for Duplicate License Certificate or License Renewal Card (call, email or write Board Office)
  • License Renewal Form with Disclaimer Form  (If you wish to pay by credit card, you will need to log onto the licensee-only section of our website using your unique Login and Password. For assistance with this, contact the Board at (919) 861-5583 or during regular working hours.)
  • North Carolina Licensed Podiatrist Mailing List Request Form
  • Public Records Request form

Requests should be made in writing and submitted to the following:

NC Board of Podiatry Examiners
3739 National Drive, Suite 202
Raleigh, NC 27612

Contact us here or Email
(919) 861-5583