(a) A person requesting to be certified to administer immunizations pursuant to Section 3041 shall apply for a certificate from the board pursuant to an application that shall be in substantially the following form:
“Application for Optometrists to Administer Immunizations
Per California Business and Professions Code §3041(g), you must have a current California Optometrist License and have a Therapeutic Pharmaceutical Agents (TPA) license type to be eligible for a certificate to administer immunizations. “Immunization” means the administration of immunizations for influenza, herpes zoster virus, pneumococcus, and SARS-CoV-2, consistent with recommendations adopted pursuant to Section 120164 of the Health and Safety Code, for persons 18 years of age or older.
If eligible, you must also meet and maintain the following requirements for an immunization certificate: