ADDRESS CHANGE FORM

You must inform the Board of any change in your office or home address within 30 days of the change as required by Board Rule 4734-6-07. You are prohibited from filing a post office box address without also disclosing the actual physical location of the address you are reporting.

All licensees must file with the Board the business name and address of all facilities that provide or administrate health related services in which they are employed, own, operate, manage or otherwise have any ownership or fiduciary interest within the state of Ohio.

All address changes must be filed in the eLicense Portal.

  • Go to the eLicense Portal
  • If you have not yet created an account in the Portal, you will first need to create your account*
  • Click on “Login/Create Your Account”
  • Click on “I Have A License”
  • Enter the required information and click “Obtain Security Code” and you will receive an email with your security code.
    • If you receive an error stating that your information cannot be found, you must contact the Board office by phone for login assistance.
  • Once you complete your registration and create a password for your account, you will be transferred to your Dashboard.
  • On your Dashboard click “Options” and choose “Change Address”
  • Follow the instructions provided to change your address

*If you have already created an account in the Portal, Login and click “Options” on your Dashboard and choose “Change Address”

Click here to go to the Portal to get started!

CONTACT

Kelly Caudill, Executive Director
77 South High Street, 16th Floor
Columbus, OH 43215
614-644-7032 | 888-772-1384
Fax 614-752-2539