background="/menu/images/oprbackground.jpg" link="#4169c1" vlink="#333399" alink="#4169c1" leftmargin="10" rightmargin="10" topmargin="0">Vermont Secretary of State's Office
Office of Professional Regulation

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Application for Preliminary Sunrise Review Assessment

1.  Profession/Occupation seeking regulation

Name

2.  Person/Organization submitting application:

Name

Organization

Address: (Street) (City) (State) (Zip Code)

Phone # FAX # E-mail

3.  Vermont Society/Association - (Attach copies of Standards of Practice and Code of Ethics)

Name

Contact Person

Address: (Street) (City) (State) (Zip Code)

Phone # FAX # E-mail

4.  National Society/Association - (Attach copies of Standards of Practice and Code of Ethics)

Name

Contact Person

Address: (Street) (City) (State) (Zip Code)

Phone # FAX # E-mail

5.  Does the National Organization have a license or certification process?   YES   NO
      If yes, attach supporting documentation.

6.  List other states currently regulating this profession/occupation. For each state attach copies of the laws and rules.

             ___________________    ___________________    ___________________    ___________________

             ___________________    ___________________    ___________________    ___________________

             ___________________    ___________________    ___________________    ___________________

             ___________________    ___________________    ___________________    ___________________

             ___________________    ___________________    ___________________    ___________________

7.  Define the services provided by this profession/occupation. What is the Scope of Practice?

When space provided is insufficient, attach additional sheets as needed

8.  What harm or danger to the health, safety, or welfare of the public can be demonstrated if the practice of this profession/occupation were to remain unregulated? (Note: The potential for harm must be recognizable and not remote of speculative.)

When space provided is insufficient, attach additional sheets as needed

9.  What benefit can the public reasonably expect if this profession/occupation is regulated and how would it be measured?

When space provided is insufficient, attach additional sheets as needed

10.  Why isn't the public protected from unprofessional practitioners through means other than regulation? (For example, criminal penalties, consumer fraud laws, small claims court, civil litigation, etc.)?

When space provided is insufficient, attach additional sheets as needed

11.  Are you seeking Licensure, Certification or Registration? _____________________________________________
See 26 V.S.A. 3101a. Definitions.

12.  a.  What other regulated professions/occupations perform similar services to those of this profession/occupation?

             ___________________    ___________________    ___________________    ___________________

             ___________________    ___________________    ___________________    ___________________

             ___________________    ___________________    ___________________    ___________________

    b.  How will the program distinguish between or among respective scopes of practice?

When space provided is insufficient, attach additional sheets as needed

13.  How many practitioners of this profession/occupation do you estimate are practicing in Vermont? ____________

14.  Estimate the percentage of the practitioners practicing in the following settings.

Independent: ________ Clinics: ________ Hospitals: ________

Other: _________________________________________________________________

15.  Is formal education required?   YES   NO   If yes, complete below.

Educational Requirements

Where may this education be obtained?

16.  Is supervised experience required in addition to, or instead of, formal education?   YES   NO   If yes, complete below.

Experience Requirements

Where may this experience be obtained?

17.  Is there a National examination?   YES   NO   If yes, complete below.

Name and Address of Examination Agency

18.  Does this profession/occupation need continuing education?   YES   NO   If yes, explain below.

When space provided is insufficient, attach additional sheets as needed

19.  Based on the criteria you propose as a requirement to become licensed/certified/registered estimate how many of the current practitioners will qualify? __________________

20.  What transitional provisions/"grandfather provisions" do you propose for current practitioners to obtain licensure/certification/registration?

When space provided is insufficient, attach additional sheets as needed

21.  Attach copies of any proposed legislative bill(s) related to this request.

22.  Attach a list of all interested persons or groups in favor of, or opposed to, this request. Have they been consulted?

23.  Include any statistical data on disciplinary actions for this profession/occupation in other states.



Go to Administrative Rules for Procedures for Preliminary Sunrise Review Assessments

Return to Professions Home Page

Return to Professional Regulation Home Page
E-mail questions and comments about these pages to
Christopher D. Winters, Director, Office of Professional Regulation
(opr@sec.state.vt.us)