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This document is an order from the New York State Board for Professional Medical Conduct regarding the application of Dr. James Hopkins to surrender his medical license due to professional misconduct.
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How to fill out New York State Board for Professional Medical Conduct Order

01
Obtain the New York State Board for Professional Medical Conduct Order form from the official website or designated office.
02
Read the instructions carefully to understand the requirements for filling out the form.
03
Provide your personal information including name, address, and contact details in the appropriate sections.
04
Complete the details regarding your professional practice, including license number and specialization.
05
Answer any specific questions related to the conduct or actions that triggered the order, providing detailed and accurate information.
06
Attach any required documentation that supports your case, such as medical records or correspondence.
07
Review the completed form for accuracy and completeness before submission.
08
Sign and date the form as required, acknowledging the information provided is true to the best of your knowledge.
09
Submit the completed form to the designated office, either by mail or electronically, following the submission guidelines provided.

Who needs New York State Board for Professional Medical Conduct Order?

01
Medical professionals who have received a notice of investigation or punitive action regarding their conduct.
02
Practitioners who are seeking to appeal a disciplinary decision made against them.
03
Health care providers in New York State looking for clarification or guidelines in response to a conduct issue.
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Health professionals study, diagnose, treat and prevent human illness, injury and other physical and mental impairments in accordance with the needs of the populations they serve.
The New York State Health Department's Office of Professional Medical Conduct (OPMC) and the state Board for Professional Medical Conduct (board) are responsible for investigating and adjudicating complaints against physicians, physician assistants, and specialist assistants*.
1-800-663-6114 - Complaints/Inquiries (Monday-Friday 9:00 a.m - 5:00 p.m.)
Engaging in acts of gross incompetence or gross negligence on a single occasion, or negligence or incompetence on more than one occasion. Permitting or aiding an unlicensed person to perform activities requiring a license. Refusing a client or patient service because of race, creed, color, or national origin.
Applicants must have completed at least one year of clinical residency training in an accredited program and must possess or be eligible for a full and unre- stricted New York State medical license. Licensure must be obtained by the program start date.
The New York State Department of Health (the Department) has been overseeing the health, safety, and well-being of New Yorkers since 1901 – from vaccinations to utilizing new developments in science as critical tools in the prevention and treatment of infectious diseases.
The Office of Professional Medical Conduct reviews all complaints of professional medical misconduct against licensed physicians, physician assistants and specialist assistants, including complaints of sexual harassment and assault.
Doctor Complaint Agency: New York State Department of Health. Division: Professional Medical Conduct. Phone Number: (800) 663-6114. Business Hours: Monday - Friday: 8 AM - 4:45 PM.

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The New York State Board for Professional Medical Conduct Order is a formal directive issued by the board that addresses issues of professional misconduct among licensed medical professionals in New York State.
Licensed medical professionals, including physicians and other practitioners registered to practice in New York State, are required to file reports or orders related to professional misconduct.
To fill out the order, a licensed medical professional must provide detailed information about the misconduct, including the nature of the violation, dates, involved parties, and any relevant evidence or documentation.
The purpose of the New York State Board for Professional Medical Conduct Order is to ensure accountability and uphold professional standards among medical practitioners, thereby protecting public health and safety.
Information that must be reported includes the identity of the medical professional involved, the specifics of the misconduct, dates and times of incidents, relevant evidence, and actions taken in response to the misconduct.
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