- This page, Report a change or addition in supervising physician or work setting, is offered by
- Board of Registration of Physician Assistants
- Bureau of Health Professions Licensure
- Department of Public Health
Report a change or addition in supervising physician or work setting
Contacts
Board of Registration of Physician Assistants
Phone
The Details of Report a change or addition in supervising physician or work setting
What you need for Report a change or addition in supervising physician or work setting
Notify the Board all information related to your supervising physician and work setting if you are a licensed Physician Assistant or temporary certificate holder in Massachusetts.
You may complete a report form to:
- Add an initial or additional supervising physician
- Replace your current supervising physician
- Terminate a supervising physician
- Change your work setting information
How to report Report a change or addition in supervising physician or work setting
Mail your completed and signed Supervising Physician and Work Setting Information Form to:
MA Board of Registration of Physician Assistants
250 Washington Street
Boston, MA 02108
Please keep a copy for your records.