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Applicant Details
Which address would you like your mail sent to?
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Your Character
Have you ever been convicted of a criminal offence? (Parking and minor traffic offences only punishable by fine may be excluded).
Please provide your name when the offence was committed and nature of the offence.
Please provide the date of the conviction and sentence (e.g. term of imprisonment/fine/probation etc.)
Criminal Record Check Clearances
You are required to complete a criminal record check that includes working with children or vulnerable adults to become a member of OsteopathyBC. Please complete the online criminal record check at https://justice.gov.bc.ca/criminalrecordcheck and use the access code: UHZFSEYMPP . After entering the code, you will have the option to apply and consent to a criminal record check. For the job title field enter “Osteopathic Practitioner”. There is no charge for this service. The results of the criminal record check will be emailed directly to OsteopathyBC. Note: If you are a member of a regulated health profession in BC and you have a valid criminal record clearance for that regulatory college within the past 5 years, please use the option available on the online webform to share your criminal record check with OsteopathyBC. For assistance, email info@osteopathybc.ca . Please select the option(s) below that best apply to you.
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Professional Education & Qualifications:
In order to be an OBC member, you MUST :
Show proof of having graduated from a full-time program of osteopathic study lasting at least 4 years (Diploma from a full-time osteopathic program); OR
Show proof of having graduated from a program with equivalent comprehensive osteopathic training (Diploma or degree in health care and Diploma from a full or part-time osteopathic program)
Please check the OBC website for recognized training institutions or contact info@osteopathybc.ca NOTE: **OBC does not recognize diplomas from primarily online osteopathic educational programs. If not applicable, enter N/A.
At which school(s) did you study Osteopathy? Please include the name of school(s), city and country.
Full Name of Osteopathic Diploma or Osteopathic Degree
Number of Years of Study (e.g. 4 or 5)
Full or Part-time Program
Designation (e.g. D.O.M.P., M. Ost., M.OMSc, etc)
Was there a research (study/thesis/project) component?
Please provide information on the research study/thesis:
Please include all below information in the text box:
Thesis or Study Title
Location (city, country) of Presentation
Date of Presentation (dd/mm/yyyy)
What education/professional health qualifications did you have upon entry to your full or part-time osteopathic studies? (E.g. Prior health care diploma, Bachelor of Science, etc.) If you completed a four-year full-time or five-year full-time osteopathic program and do not have a prior health care qualification, please answer N/A.
Please list attainment dates for the above list (mm/yyyy).
How many years of experience did you have in your previous health profession(s) if applicable?
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Professional Experience as an Osteopathic Practitioner (if not applicable enter N/A):
When did you first practise osteopathy? (mm/yyyy)
In which countries have you practised, and when?
Describe the type and scope of your practise referred to above.
Are you currently practising osteopathy?
Please explain why you are not practising osteopathy and provide details:
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Professional Negligence and/or Misconduct:
Has any allegation of professional negligence in relation to your practice of osteopathy been made against you in any province and/or country?
Was the allegation of negligence found to have been proved?
Please give the details of any judgement of the negligence which was given against you.
Has any allegation of professional misconduct in relation to your practice of osteopathy been made against you in any province and/or country?
Was the allegation of misconduct found to have been proved?
Please give the details of any judgement for the misconduct which was given against you.
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Professional Liability Insurance:
Are you currently protected by at least a 2 million dollar policy of osteopathic professional liability insurance for British Columbia?
If you answer No, you will be required to obtain insurance upon approval of your membership application and you will be provided with options of where to purchase a policy.
During which periods have you held such insurance in the past?
Have you ever been required to pay an increased premium for such insurance?
If you know why you were required to pay an increased premium, or why you were quoted insurance on loaded terms, or why you have been refused insurance, please give details:
Have you ever been refused such insurance?
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Professional Associations, Regulatory Bodies and Disciplinary Proceedings:
Are you a member of any provincial, national or international osteopathic organization(s)?
Please name the osteopathic organization(s) and include the dates you were a member of the osteopathic organization(s).
Are you a member of any other professional healthcare organization(s)?
Please name the healthcare organization(s) and include the dates you were a member.
Have you been on a register maintained by a professional regulatory body?
Please list name(s) of the regulatory body with the dates when you were registered.
Have you ever been refused registration as an osteopath/osteopathic practitioner by any professional regulatory body in any country or in any Canadian province?
Please name the professional regulatory body and say the reasons given for refusal.
Have you ever been struck off any register by a professional regulatory body?
Please give details of the register and the date.
Reason for being struck off by professional regulatory body.
Have you ever been suspended by a professional regulatory body from providing osteopathic or other professional services?
Please give details of the professional regulatory body and the dates during which the suspension was effective.
The reason why you were suspended from a professional regulatory body.
Have there ever been any other disciplinary findings made against you by a professional regulatory body?
Please give details of any other disciplinary findings made against you by a professional regulatory body.
Are there any unresolved complaints against you that have been made to a professional regulatory body?
Please name the professional regulatory body(ies) and date(s).
Nature of each unresolved complaint.
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CONSENTS:
1. I consent to OBC forwarding my required contact and membership information to insurance companies for the purpose of procuring or maintaining osteopathic coverage for OBC members.
2. As a member, you will receive regular email updates from OBC. Communications may include e-newsletters, membership and association information and details on upcoming conferences, training and events organized by OBC and/or its partner organizations. Please indicate below if you give permission for your email address to be added to the OBC communication list.
Please note you will not receive any communications from OBC. You may miss important notifications about your benefits and educational opportunities.
3. I consent to the OsteopathyBC/SPMPO Board contacting me via the preferred email I have supplied for official notification of legally required membership-related information such as election notifications, Bylaw amendments, and Annual General Meeting notices.
Please be aware that OBC is legally required under the BC Societies Act to notify its members of elections, Bylaw amendments and Annual General meetings, and you will be sent this information by mail.
4. I consent to being contacted by email for the purpose of research by osteopathic researchers and osteopathic student researchers.
5. I consent to have my name and contact details listed on the OBC website.
By selecting no, please note the public will not be able to search for your osteopathy practice on the website and may not be aware of your practice.
6. I consent to have my name included in OBC materials created for members only.
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