Illegal use of illicit or controlled substances means the use of substances obtained illegally (e.g., heroin or cocaine) as well as the use of controlled substances that are not obtained pursuant to a valid prescription or not taken in accordance with the directions of a licensed health care practitioner.
Illegal use of illicit or controlled substances means the use of substances obtained illegally (e.g., heroin or cocaine) as well as the use of controlled substances that are not obtained pursuant to a valid prescription or not taken in accordance with the directions of a licensed health care practitioner. QUESTIONS: Please respond to ALL questions. If you answer "YES" to any question, please attacha written explanation. 4. Are you currently participating in a supervised rehabilitation program or professional assistance program that monitors you to assure that you do not consume alcohol and/or do not engage in the illegal use of illicit or controlled substances? 5. Have you ever been diagnosed as having or have you ever been treated for pedophilia, exhibitionism, voyeurism or other diagnosis of a predatory nature? 6. Have you ever held or applied for a license, privilege, registration or certificate to practice social work in any state, country, or province, that has been or was ever denied, reprimanded, suspended, restricted, revoked, otherwise disciplined, curtailed, or voluntarily surrendered under threat of investigation or disciplinary action? 7. Have you ever held or applied for a license, privilege, registration or certificate to practice social work in any state, country, or province, that has been or was ever denied, reprimanded, suspended, restricted, revoked, otherwise disciplined, curtailed, or voluntarily surrendered under threat of investigation or disciplinary action? 8. Have you ever applied for or held a state or federal controlled substance certificate that was ever denied, revoked, suspended, restricted, voluntarily surrendered or otherwise disciplined or surrendered under threat of restriction or disciplinary action? 9. Have you ever been convicted (including a nolo contendere plea or guilty plea) of a felony or misdemeanor (other than a minor traffic offense) whether or not sentence was imposed or suspended? 10. Have you ever been rejected or censured by a professional association or society? 11. In relation to the performance of your professional services in any profession: a. Have you ever had a final judgment rendered against you; b. Have you ever entered into any settlement of any legal action; or c. Are there any legal actions pending against you or to which you are a party? 12. Have you ever held a license, registration, privilege or certificate in any profession that has ever been reprimanded, suspended, restricted, revoked, otherwise disciplined, curtailed, or voluntarily sur...
Illegal use of illicit or controlled substances means the use of substances obtained illegally (e.g., heroin or cocaine) as well as the use of controlled substances that are not obtained pursuant to a valid prescription or not taken in accordance with the directions of a licensed health care practitioner. QUESTIONS: Please respond to ALL questions. If you answer "YES" to any question, please attach a written explanation.YESNO1. 1. Do you currently have any physical or psychological limitations or impairments caused by an existing medical condition which are reduced or ameliorated by ongoing treatment or monitoring, or the field of practice, the setting or the manner in which you have chosen to practice?2. Do you currently use any chemical substances which in any way impair or limit your ability to practice your profession with reasonable skill and safety? If so, please list (If you receive such ongoing treatment or participate in such a monitoring program, the Board will make an ind severity, and the duration of the risks associated with an ongoing medical condition so as to be determine whethe issued, whether conditions should be imposed, or whether you are not eligible for licensure.)ividual assessment of th r an unrestricted licensee nature, the should be 3. At any time within the past two years, have you engaged in the illegal use of illicit or controlled substances? 4. Are you currently participating in a supervised rehabilitation program or professional assistance program that monitors you to assure that you do not consumealcohol and/or do not engage in the illegal use of illicit or controlled substances? 5. Have you ever been diagnosed as having or have you ever been treated for pedophilia, exhibitionism, voyeurism or other diagnosis of a predatory nature? 6. Have you ever held or applied for a license, privilege, registration or certificate to practice social work in any state, country, or province, that has been or was ever denied, reprimanded, suspended, restricted, revoked, otherwise disciplined, curtailed, or voluntarily surrendered under threat of investigation or disciplinary action?
More Definitions of Illegal use of illicit or controlled substances
Illegal use of illicit or controlled substances means the use of substances obtained illegally (e.g., heroin or cocaine) as well as the use of controlled substances that are not obtained pursuant to a valid prescription or not taken in accordance with the directions of a licensed health care practitioner. QUESTIONS: YES NO 1. Do you currently have any condition that is causing impairment that affects your ability topractice medicine with reasonable skill and safety in a competent, ethical and professional manner? (You may answer no if you are being appropriately treated and are not impaired.) 2. Do you currently use any medications or substances (legal, OTC, prescribed or illicit) which in any way impairs or limits your ability to practice medicine with reasonable skill and safetyin a competent, ethical and professional manner? If so, please list: [If you receive such ongoing treatment or participate in such a monitoring program, the Board will make an individual assessment of the nature, the severity, and the duration of the risks associated with an ongoing medical condition so as to determine whether an unrestricted license should be issued, whether conditions should be imposed, or whether you are not eligible for licensure.]COMPETENCY INFORMATIONCONTINUEDQUESTIONS: Please respond to ALL questions. If you answer "YES" to any question, please attach a written explanation. Affirmative response requires final documents or orders from the issuing states, courts, and/or agencies. YES NO 3. During the past two years, did you engage in any activity involving substances, either alcoholor controlled/illicit drugs, that has created or might create a challenging pathway for you in your current or future professional career if continued? If so and you answer “question, the Board is prepared to offer an evaluation by the Tennessee Medical Foundation’s Physictoidaetenrmsine Hthee baelst tpahthwaPy rto olicgenrsuaremfor you as you begin or continue your career in the State of Tennessee. It should be noted, however, that if such activity is not revealed, but manifests at some later time in your career, the Board, in its role as the protector of the health, safety and welfare of people in the State of Tennessee, will be able to pursue a disciplinary action on your license. 4. Are you currently participating in a Professional Health Program (PHP) or similar type program that provides monitoring and advocacy for you for a physical, mental health orsubstance use disorder which has caused you impairment? 5. Have you ever ...