Order Reports

Overview

Please click the "Begin" button below and fill out the form to request your Part III (PMLexis) Score and/or Disciplinary reports to be sent to State Boards or Residency Programs 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.
PART I & II: To send a copy of your Part I and/or Part II examination scores to a state board, federal agency, hospital or institution, visit the APMLE web site: http://www.apmle.com.

MANAGED CARE / CREDENTIALING VERIFICATION ORGANIZATIONS: This form is strictly reserved for individuals ordering reports to be sent to State Boards or Residency Programs. The MC/CVO version of this form is available once you have logged in with your credentials. To create an account, contact the FPMB Executive Office.

Order Information

*Indicates a Required Field
*How many DESTINATIONS (State Boards, Residencies, Fellowships, VAs, etc.) are in this order?

DESTINATION #1:
*Destination Type:


DESTINATION #2:
*Destination Type:


DESTINATION #3:
*Destination Type:


DESTINATION #4:
*Destination Type:

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Contact Information

*Indicates a Required Field
  *FIRST Name:
*Date of Birth: (Format: 01/01/1950)
 
Middle Name: (optional)
*Social Security Number: (Format: 123-45-6789)
*LAST Name:
*Phone Number: (Format: 202-555-1212)
Maiden Name: (optional)
*Email Address: (Format: name@provider.com)
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.)
  *Address:
*Country:
 
Address (line 2): (optional)
*State:
*Province:
*City:
*ZIP Code: (Format: 12345) *Postal Code: (Format: A1A 1A1)

YOUR Billing Address:
Is your billing address the same as your mailing address? (Credit Card Orders - Billing Address must match card.)
  *Address:
*Country:
 
Address (line 2): (optional)
*State:
*Province:
*City:
*ZIP Code: (Format: 12345) *Postal Code: (Format: A1A 1A1)
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Review and Place Order

Name:
Date of Birth Social Security Number
Phone Number Email Address
Your Mailing Address Your Billing Address
Order ID:
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.