Section Med 305.01 - Locum Tenens Licenses(a) Applicants who currently hold a full, unrestricted medical license in another state, and who wish to practice in New Hampshire for a limited period of time may apply for a restricted license.(b) Locum tenens licenses shall be issued by the board subject to the following limitations: (1) No locum tenens license shall be valid for a period in excess of 100 consecutive calendar days;(2) Locum tenens licenses shall be valid for practice only at the location specified on the face of the license;(3) Only one locum tenens license shall be issued to any applicant during any 12 month period; and(4) Locum tenens licenses shall be posted at the location specified on the face of the license at all times during the period of licensure.(c) Applicants for locum tenens licensure shall provide, or cause to be provided, the following on or attached to an "Application for Locum Tenens License," revised 11/2019: (1) The applicant's name, gender, and residence address;(2) The address(es) and telephone number(s) of the applicant's prior 3-year practice location(s);(3) The applicant's date and place of birth;(4) The name of the institution where the applicant graduated from medical school and the date of graduation;(5) The name of the institutions where the applicant completed his or her post graduate training and the dates of that training;(6) Disclosure of whether the applicant has ever previously applied for licensure in New Hampshire and if so, the date of that application;(7) Disclosure of whether the applicant has ever been subject to disciplinary action by any licensing or certifying agency or by any hospital or health care institution and if so, the dates and circumstances of that action;(8) Disclosure of whether the applicant has had any medical malpractice suit brought against him or her or has had any claim settled on his or her behalf in the last 10 years;(9) The state in which the applicant holds current licensure and clearance of that license received directly from the state licensing authority indicating that the applicant's license covers the dates in which he or she is practicing in New Hampshire;(10) The name and address of the New Hampshire health care facility at which the applicant will be practicing;(11) The dates during which the applicant will be practicing and verification of those dates received directly from the New Hampshire healthcare facility at which the applicant will be practicing;(12) The signature of the applicant; and(13) Original letters of reference, on letterhead and addressed to the board, from: a. The chief medical officer or president of the medical staff in every hospital in which the applicant currently holds staff privileges; orb. Letters of reference from 2 practicing physicians. (d) Applicants shall include the application fee required in Table 3.6.1 in Med 306.01.N.H. Admin. Code § Med 305.01
#4970, eff 11-8-90; amd by #5838, eff 6-17-94; amd by #5908, eff 10-7-94; ss by #6576, eff 9-15-97; amd by #6906, eff 12-4-98; amd by #8662, INTERIM, eff 6-16-06, EXPIRED: 12-13-06 (paragraphs (a), (c), and (d)); ss by #8945, eff 7-18-07; ss by #9900, eff 4-12-11 (see Revision Note at chapter heading for Med 300)
Amended by Volume XL Number 7, Filed February 13, 2020, Proposed by #12972, Effective 1/10/2020, Expires 1/10/2030