Inital Limited License Applications

Downloadable Application Kits for Initial Limited License

Applicants for limited licensure in Massachusetts may download any or all of the following forms for use in preparing their application.

• Do not send these forms to the Board of Registration in Medicine. All completed forms must be sent to your training program.
  
• Do not complete and mail these forms until you have been accepted into an accredited training program.
  
• Each kit has a set of instructions. Please read the instructions carefully before filling out the forms.

Documents

• Initial Limited License Application Kit 
• Initial Limited License Frequently Asked Questions 
• Application Instructions 
• Application Checklist 
• Initial Limited Application 
• Medical Education Verification 
• State License Verification 
• Evaluation Form 
• Authorization for Release 
• Name Change Form 
• Equivalency Waiver 
• Form E-1 
• Form E-2 
  

This information is provided by the Board of Registration in Medicine.