Petition for retired physician assistant status

Physician assistants can petition the Board to request their licenses be placed on retired status. A retired status is a non-disciplinary status.

Board of Registration of Physician Assistants

The Details of Petition for retired physician assistant status

What you need for Petition for retired physician assistant status

You are eligible to submit a petition for retired status, if you:

  • Meet the eligibility requirements in 263 CMR 3.07
  • Have a license that is not surrendered, suspended, or revoked at the time of the petition
  • Demonstrate, to the board's satisfaction, that you intend to permanently retire from active practice in the Commonwealth and in all other jurisdictions

You will also need your:

  • License number
  • Address
  • Telephone number
  • Email address
  • Date of birth

How to submit Petition for retired physician assistant status

  1. Download and complete the form, found below
  2. Mail completed form to:

    Board of Registration of Physician Assistants
    239 Causeway St.
    5th Floor, Suite 500
    Boston, MA 02114
  1. Download and complete the form, found below
  2. Fax completed form to (617) 973-0980

Downloads for Petition for retired physician assistant status

Contact for Petition for retired physician assistant status

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