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