CE Summary Form 2026-2028

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This form may be submitted upon completion of the required CE hours. Early submission is encouraged and may assist in more timely renewal processing.
I,*
,O.D., Nevada License Number*
Email*
hereby submit copies of documents reflecting my attendance at or participation in sufficient courses to fulfill the continuing education requirements for license renewal pursuant to NRS 636.260 and Board Policy Number 5. I completed the following courses between March 1st of the current license period and the date entered below.
1. Optometric Pharmaceutical Agents Certificate (OPAC) formerly TPA (Therapeutic Pharmaceutical Agents)
1. Optometric Pharmaceutical Agents Certificate (OPAC) formerly TPA (Therapeutic Pharmaceutical Agents)
Do you hold an OPAC?
- Yes
- No
Yes, I hold an OPAC , I have completed the following number of hours related to the diagnosis or treatment of conditions of the eye or prescribing optometric pharmaceutical agents.*
Yes, I hold an OPAC.
(The required number of hours is 50, not fewer than 30 must relate to the diagnosis or treatment of conditions of the eye or prescribing optometric pharmaceutical agents. Up to 10 hours may be related to optometric office administration or practice management.)
I have completed the following number of hours related to the diagnosis or treatment of conditions of the eye or prescribing optometric pharmaceutical agents.
10 hours is the maximum allowed in the subject of practice management. I have completed the following amount of practice management hours*
No, I do not hold an OPAC.
(The minimum required hours is 40, of which up to 5 hours may be related to optometric office administration or practice management).
5 hours is the maximum allowed in the subject of practice management. I have completed the following amount of practice management hours*
2. Drug Enforcement Administration (DEA) number and/or a Nevada Controlled Substances (CS) number
2. Drug Enforcement Administration (DEA) number and/or a Nevada Controlled Substances (CS) number
Do you hold a DEA number and/or Nevada CS number?
- Yes
- No
Yes, I hold a federal DEA number and/or Nevada CS number.
I affirm that I have completed at least 2 hours related to prescribing opioids, addiction, substance abuse and/or pain management. The course title(s) are*
- I affirm that I have completed at least 2 hours related to prescribing opioids, addiction, substance abuse and/or pain management. The course title(s) are
Opioid related courses taken*
No I do not hold a DEA number and/or Nevada CS number.
3. I affirm that I did not complete more than 10 hours of continuing education within any 24-hour period.*
3. I affirm that I did not complete more than 10 hours of continuing education within any 24-hour period.
- I affirm that I did not complete more than 10 hours of continuing education within any 24-hour period.
4. CE certificates uploads
4.1 If you possess an OE Tracker Report/ CE Wire Report, upload it below:
Drop files here or

Accepted file types: jpg, jpeg, png, doc, docx, pdf, Max. file size: 20 MB, Max. files: 20.
4.2 If you do NOT possess an OE Tracker Report/ CE Wire Report, upload all CE completion certificates below:
Drop files here or

Accepted file types: jpg, jpeg, png, doc, docx, pdf, Max. file size: 20 MB, Max. files: 20.
If unable to upload all files due to file size or file limit, submit additional CE Summaries as needed to upload all files.
- Dated :*
  MM slash DD slash YYYY
*
- By submitting this information and checking this box, I affirm that each document is complete and correct and that all information contained in this submission is true under the pains and penalties of perjury and the requirements of NRS Chapter 636 and NAC Chapter 636 and Nevada law generally. I also acknowledge that if I have directed or authorized a person to complete or submit this information on my behalf, I, the optometrist licensed by the Nevada Board of Optometry, am fully responsible for the content of the submission.
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CE Summary Form 2026-2028

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