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Order Reports

Select Who You Are Below:

Podiatrist YOU are, or represent, a PODIATRIST and want to order a report to be sent to a destination. Organization YOU represent an ORGANIZATION (ex: hospital, CVO) and want to order a report on a podiatrist to be sent to your organization.
Order Reports - Podiatrists (no account needed)
NOTE:The FPMB continues to process Part I/II/III (PMLexis) Score and Disciplinary reports without interruption; however, State Boards may require additional time. For COVID-19 information for your state, including guidance for health care providers, please visit the FPMB's COVID-19 web page.
Podiatristscan request that the Federation of Podiatric Medical Boards send their Part I/II/III (PMLexis) Score and/or Disciplinary reports to State Boards, Residencies, Fellowships, VAs, etc. only. Reports cannot be sent to individuals. After completing the form, you will have the option to pay online by credit card -or- print out a form to mail in with a check.
Frequently Asked Questions
  • How are reports sent to destinations?
    Most destinations, including approximately 90% of State Boards, are sent reports via electronic delivery. Alternatively, reports are sent via postal mail.
  • How long is turnaround time?
    The FPMB typically processes report requests within two business days. Destinations that accept electronic delivery typically download reports within two business days. For reports sent via postal mail, allow two to four days for the post office to deliver reports to the destination, plus time for the destination's mail room to deliver reports to the recipient's desk.
  • How will you know that the FPMB received your order?
    Podiatrists that place an order online, and pay via credit card, will receive an email receipt that also serves as confirmation that your order has been received.
  • How will you know that the FPMB processed your order?
    Podiatrists that place an order online will receive an email notification when the FPMB has processed your order.
  • How will you know that the destination received your order?
    For destinations that participate in electronic delivery, podiatrists will receive email notification(s) when the destination(s) download the report(s).
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Order Reports - Organizations
Organizations must have an online account to place orders. To create an account, please download, complete and return the Website User Account Request Form.
Organizations (managed care, CVOs, etc.) can request that the Federation of Podiatric Medical Boards send Disciplinary reports on podiatrists via our fast, secure and convenient online system. After completing the form, you will have the option to pay online by credit card -or- print out a form to mail in with a check. Processed reports are returned to organizations via secure electronic delivery.
Frequently Asked Questions
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Order Reports - Organizations

Contact Information

Please verify that all contact and address information below is accurate. If any of this information is incorrect, do not proceed with this order and contact the FPMB at fpmb@fpmb.org.
ELECTRONIC DELIVERY
(for email notification to download completed reports)
Name
Title
Email Address
BILLING INFORMATION
(if paying by credit card; receipt is sent to this email address)
Name
Company
Address
City/State/ZIP Code
Phone Number
Email Address
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Order Information

Indicates a Required Field
How many PROVIDERS are in this order? REQUIRED: How many PROVIDERS are in this order?

PROVIDER #1:
FIRST Name REQUIRED: First Name #1
Middle Name
LAST Name REQUIRED: Last Name #1
Maiden/Alternate Name
Date of Birth REQUIRED: Date of Birth #1 INVALID: Date of Birth #1 [format: 1/1/1950] (format: 1/1/1950)
Social Security Number REQUIRED: Social Security Number #1 INVALID: Social Security Number #1 [format: 123-45-6789] (format: 123-45-6789)
PROVIDER #2:
FIRST Name REQUIRED: First Name #2
Middle Name
LAST Name REQUIRED: Last Name #2
Maiden/Alternate Name
Date of Birth REQUIRED: Date of Birth #2 INVALID: Date of Birth #2 [format: 1/1/1950] (format: 1/1/1950)
Social Security Number REQUIRED: Social Security Number #2 INVALID: Social Security Number #2 [format: 123-45-6789] (format: 123-45-6789)
PROVIDER #3:
FIRST Name REQUIRED: First Name #3
Middle Name
LAST Name REQUIRED: Last Name #3
Maiden/Alternate Name
Date of Birth REQUIRED: Date of Birth #3 INVALID: Date of Birth #3 [format: 1/1/1950] (format: 1/1/1950)
Social Security Number REQUIRED: Social Security Number #3 INVALID: Social Security Number #3 [format: 123-45-6789] (format: 123-45-6789)
PROVIDER #4:
FIRST Name REQUIRED: First Name #4
Middle Name
LAST Name REQUIRED: Last Name #4
Maiden/Alternate Name
Date of Birth REQUIRED: Date of Birth #4 INVALID: Date of Birth #4 [format: 1/1/1950] (format: 1/1/1950)
Social Security Number REQUIRED: Social Security Number #4 INVALID: Social Security Number #4 [format: 123-45-6789] (format: 123-45-6789)
PROVIDER #5:
FIRST Name REQUIRED: First Name #5
Middle Name
LAST Name REQUIRED: Last Name #5
Maiden/Alternate Name
Date of Birth REQUIRED: Date of Birth #5 INVALID: Date of Birth #5 [format: 1/1/1950] (format: 1/1/1950)
Social Security Number REQUIRED: Social Security Number #5 INVALID: Social Security Number #5 [format: 123-45-6789] (format: 123-45-6789)
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Review and Place Order

INSTRUCTIONS
7/10/2020 5:25 PM ET
  1. Print a copy of this order by clicking the "PRINT ORDER" button below.
  2. Make check payable to the "Federation of Podiatric Medical Boards" for the TOTAL amount displayed below.
  3. Send the check and a copy of this request to:
Federation of Podiatric Medical Boards
12116 Flag Harbor Drive
Germantown, MD 20874-1979
Do not send by Registered, Certified or Express Mail -- this will delay processing your request.
**You will receive an email notification when your order has been processed.**
Please allow up to ten (10) business days from the date that payment is received for your order to be processed.
PAYMENT STATUS: ACCEPTED
7/10/2020 5:25 PM ET
Print a copy of this order as a receipt by clicking the "PRINT ORDER" button below.
**You will receive an email notification when your order has been processed.**
Please allow up to ten (10) business days for your order to be processed.
NAME
TITLE
Phone Number
Email Address (for delivery)
ORDER ID
Provider 1
Provider 2
Provider 3
Provider 4
Provider 5
TOTAL
ALL ORDERS ARE FINAL. NO REFUNDS WILL BE PROVIDED.
INSTRUCTIONS
  1. In the Order Summary section, verify the Order Amount and Description.
  2. In the Credit Card Information section, enter your credit card (Visa or MasterCard) information.
  3. In the Billing Information, verify that your name and contact information are correct.
  4. Click the Process Payment button.
NOTE: To pay by check, click the Review Order button below.
ALL ORDERS ARE FINAL. NO REFUNDS WILL BE PROVIDED.
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We are sorry, but your payment was declined for the following reason:
[Code ]:
INSTRUCTIONS
  1. If you have a problem with one credit card, you may wish to try a different card.
  2. Click the "Credit Card (try again)" button below to try again.
  3. To pay by check, click the "Pay By Check" button below.
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Pay by
Check
(print & mail)
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Pay by
Credit Card
(try again)
Order Reports - Podiatrists

Order Information

Indicates a Required Field

ERROR: The same destination has been selected more than once.
When did you take the exam(s)? (Optional, but preferred)
Part I Exam
WARNING: We are not accepting pre-orders for this exam yet.
Part II Exam
WARNING: We are not accepting pre-orders for this exam yet.
Part II CSPE Exam
WARNING: We are not accepting pre-orders for this exam yet.
The Part II CSPE exam was administered beginning with the Class of 2015, excluding the Class of 2016, and continuing with the class of 2017.
Part III Exam
WARNING: We are not accepting pre-orders for this exam yet.
NOTE: When Prometric releases your exam results, the FPMB sends them to the State Board where you applied. Do NOT use this form to place a duplicate order.
The Part III (PMLexis) exam was not administered prior to June 1987. Do NOT continue if you have not taken the Part III (PMLexis) exam.
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Contact Information

Indicates a Required Field
Please verify that you have correctly entered your "Date of Birth" and "Social Security Number" before clicking the ">> Next" button.
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Mailing Information

Indicates a Required Field
YOUR Mailing Address
(Do not provide the order destination mailing address)


YOUR Billing Address
Is your billing address the same as your mailing address? REQUIRED: Is your billing address the same as your mailing address?
(Credit Card Orders - Billing Address must match card)
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Review and Place Order

INSTRUCTIONS
7/10/2020 5:25 PM ET
  1. Print a copy of this order by clicking the "PRINT ORDER" button below.
  2. Make check payable to the "Federation of Podiatric Medical Boards" for the TOTAL amount displayed below. (Personal checks are accepted.)
  3. Send the check and a copy of this request to:
Federation of Podiatric Medical Boards
12116 Flag Harbor Drive
Germantown, MD 20874-1979
Do not send by Registered, Certified or Express Mail -- this will delay processing your request.
**You will receive an email notification when your order has been processed.**
Please allow up to ten (10) business days from the date that payment is received for your order to be processed.
PAYMENT STATUS: ACCEPTED
7/10/2020 5:25 PM ET
Print a copy of this order as a receipt by clicking the "PRINT ORDER" button below.
**You will receive an email notification when your order has been processed.**
Please allow up to ten (10) business days for your order to be processed.
NAME
Date of Birth
Social Security Number
Phone Number
Email Address
Your Mailing Address
Your Billing Address
ORDER ID
Part I Taken
Part II Taken
Part II CSPE Taken
Part III Taken
TOTAL
*
*Reports are offered at a reduced rate when sent to State Boards who are current with their membership dues for the Federation of Podiatric Medical Boards.
ALL ORDERS ARE FINAL. NO REFUNDS WILL BE PROVIDED.
Your order will resume in a moment ...
GET CONNECTED with Your State Associations of Podiatric Physicians!
State Associations provide many member benefits, including:
  • Fellowship with other Podiatrists
  • Support of your Podiatric medical career at a local and national level
  • Fostering laws to improve regulations regarding Podiatric medical care, including scope of practice
  • Interaction with colleagues and your state regulators to improve practice efficiency and revenue
  • Participation and interaction with the broader medical community within your state
Would you like the association(s) below to reach out to you with membership information? (check/uncheck, as desired)
NOTE: By clicking the "Yes" button, you grant the FPMB permission to provide your contact information to the association(s) checked above.
cancel No
check_circle Yes
INSTRUCTIONS
  1. In the Order Summary section, verify the Order Amount and Description.
  2. In the Credit Card Information section, enter your credit card (Visa or MasterCard) information.
  3. In the Billing Information, verify that your name and contact information are correct.
  4. Click the Process Payment button.
NOTE: To pay by check, click the Review Order button below.
ALL ORDERS ARE FINAL. NO REFUNDS WILL BE PROVIDED.
fast_rewind Review Order
We are sorry, but your payment was declined for the following reason:
[Code ]:
INSTRUCTIONS
  1. If you have a problem with one credit card, you may wish to try a different card.
  2. Click the "Credit Card (try again)" button below to try again.
  3. To pay by check, click the "Pay By Check" button below.
shopping_cart
Pay by
Check
(print & mail)
shopping_cart
Pay by
Credit Card
(try again)
Federation of Podiatric Medical Boards
12116 Flag Harbor Drive
Germantown, MD 20874-1979
Phone: 202-810-3762
Fax: 202-318-0091
Email: fpmb@fpmb.org
Copyright 2020 by Federation of Podiatric Medical Boards
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