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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.

Contacts

Board of Registration of Physician Assistants

Phone

Call Board of Registration of Physician Assistants at (617) 624-6189
TTY Call Board of Registration of Physician Assistants, TTY at (617) 973-0988

Online

Email Board of Registration of Physician Assistants at PhysicianAssistantsBoard@mass.gov

The Details

What you need

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

  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

Open DOCX file, 37.04 KB,  Retirement Application (DOCX) (English, DOCX 37.04 KB)

Contact

Address
250 Washington Street, Boston, MA 02108
Directions 
Phone
Call Board of Registration of Physician Assistants at (617) 624-6189
TTY Call Board of Registration of Physician Assistants, TTY at (617) 973-0988
Online
Email Board of Registration of Physician Assistants at PhysicianAssistantsBoard@mass.gov
Fax
(617) 973-0985

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