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Home > Reports > Order Reports

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)
APMLE PART I & II: To send a copy of your APMLE 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.
Podiatrists can request that the Federation of Podiatric Medical Boards send their Part 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).
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
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

Order Information

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

PROVIDER #1:
*FIRST Name
Middle Name (optional; provide if available)
*LAST Name (include suffix, if applicable)
Maiden/Alternate Name (optional; provide if applicable)
*Date of Birth (Format: 1/1/1952)
*Social Security Number (Format: 123-45-6789)

PROVIDER #2:
*FIRST Name
Middle Name (optional; provide if available)
*LAST Name (include suffix, if applicable)
Maiden/Alternate Name (optional; provide if applicable)
*Date of Birth (Format: 1/1/1952)
*Social Security Number (Format: 123-45-6789)

PROVIDER #3:
*FIRST Name
Middle Name (optional; provide if available)
*LAST Name (include suffix, if applicable)
Maiden/Alternate Name (optional; provide if applicable)
*Date of Birth (Format: 1/1/1952)
*Social Security Number (Format: 123-45-6789)

PROVIDER #4:
*FIRST Name
Middle Name (optional; provide if available)
*LAST Name (include suffix, if applicable)
Maiden/Alternate Name (optional; provide if applicable)
*Date of Birth (Format: 1/1/1952)
*Social Security Number (Format: 123-45-6789)

PROVIDER #5:
*FIRST Name
Middle Name (optional; provide if available)
*LAST Name (include suffix, if applicable)
Maiden/Alternate Name (optional; provide if applicable)
*Date of Birth (Format: 1/1/1952)
*Social Security Number (Format: 123-45-6789)

Review and Place Order

INSTRUCTIONS
8/21/2017 2:39 AM 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
8/21/2017 2:39 AM 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.
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.
Order Reports - Podiatrists

Order Information

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

DESTINATION #1:
*Destination Type
*Send Report(s) to:
*Report Types
Please provide the name, address and contact information for this destination.
NOTE: Reports cannot be sent to individuals.
*Organization Name
*Address
*Address (line 2) (optional)
*City
*Country
*State
*Province
*ZIP Code (Format: 12345) *Postal Code (Format: A1A 1A1)
*Contact Name
*Contact Title
*Phone Number (Format: 202-555-1212)
*Email Address (Format: name@provider.com)

DESTINATION #2:
*Destination Type
*Send Report(s) to:
*Report Types
Please provide the name, address and contact information for this destination.
NOTE: Reports cannot be sent to individuals.
*Organization Name
*Address
*Address (line 2) (optional)
*City
*Country
*State
*Province
*ZIP Code (Format: 12345) *Postal Code (Format: A1A 1A1)
*Contact Name
*Contact Title
*Phone Number (Format: 202-555-1212)
*Email Address (Format: name@provider.com)

DESTINATION #2:
*Destination Type
*Send Report(s) to:
*Report Types
Please provide the name, address and contact information for this destination.
NOTE: Reports cannot be sent to individuals.
*Organization Name
*Address
*Address (line 2) (optional)
*City
*Country
*State
*Province
*ZIP Code (Format: 12345) *Postal Code (Format: A1A 1A1)
*Contact Name
*Contact Title
*Phone Number (Format: 202-555-1212)
*Email Address (Format: name@provider.com)

DESTINATION #4:
*Destination Type
*Send Report(s) to:
*Report Types
Please provide the name, address and contact information for this destination.
NOTE: Reports cannot be sent to individuals.
*Organization Name
*Address
*Address (line 2) (optional)
*City
*Country
*State
*Province
*ZIP Code (Format: 12345) *Postal Code (Format: A1A 1A1)
*Contact Name
*Contact Title
*Phone Number (Format: 202-555-1212)
*Email Address (Format: name@provider.com)

When and where did you take the Part III (PMLexis) exam? (Optional - Helps expedite your request)
NOTE: The Part III (PMLexis) exam was not administered prior to 1987. Do not continue with this order if you have not taken the Part III (PMLexis) exam.
Month
Year
State

Contact Information

*Indicates a Required Field
*FIRST Name
Middle Name (optional)
*LAST Name (include suffix, if applicable)
Maiden/Alternate Name (optional)
*Date of Birth (Format: 1/1/1952)
*Social Security Number (Format: 123-45-6789)
*Phone Number (Format: 202-555-1212)
*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.

Mailing Information

*Indicates a Required Field
YOUR Mailing Address (Do not provide the order destination mailing address)
*Address
Address (line 2) (optional)
*City
*Country
*State
*Province
*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
Address (line 2) (optional)
*City
*Country
*State
*Province
*ZIP Code (Format: 12345) *Postal Code (Format: A1A 1A1)

Review and Place Order

INSTRUCTIONS
8/21/2017 2:39 AM 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
8/21/2017 2:39 AM 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 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.
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.
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.