Apply for a physician assistant license

Please refer to the Full Licensure Application (PDF) | (DOC)

Complete applications must include the following documents:

• Completed application form, signed, dated, and notarized
• 2x2 passport style color photo
  • White or off-white background
  • Copies and printer generated photos are not acceptable
• Signed and notarized Criminal Offender Record Information (CORI) Request Form (if applicable)|(DOC)
• Application fee
• Official transcripts in signed, sealed envelopes from physician assistant programs/degrees with proof of a bachelor’s degree or higher
  • When requesting official transcripts, please inform each school’s registrar that the transcript must be complete and indicate the degree and date conferred in mm/dd/yyyy format
  • NCCPA documentation of certification is required. This must be sent directly from NCCPA. Email verifications are not acceptable.
    • A form to request NCCPA verification is included in the application packet

If you are licensed in any a state or jurisdiction outside of Massachusetts

Submit verification of your licensure status, in signed, sealed envelopes, from any state or jurisdiction in which you now or have ever held any professional license or board certification. Verifications must be sent directly to the Board by the state or other jurisdictions.

• Application must be submitted on single-sided paper
• All requested information must be provided; failure to provide requested information may result in a delay in processing of application. We will return any incomplete applications.
  • Do not leave blanks. If you are unable to provide the requested information, attach a separate sheet with an explanation.
• Keep a copy of your completed application for your records. The Board is not able to provide copies of your application. Employers may require that you provide them with a copy.