Contact for Request a name change, address change, or a duplicate license for respiratory therapists
Board of Respiratory Care
The Details of Request a name change, address change, or a duplicate license for respiratory therapists
What you need for Request a name change, address change, or a duplicate license for respiratory therapists
If you are requesting changes online:
- You will need your Online Licensing username and password
- If you do not have an account yet, you may search for your records with your date of birth and SSN
- You cannot request a name change through the online portal. This must be done via mail.
If you are requesting changes through paper application, you need your:
- License number
- Social Security Number
- Date of birth
For a name change
You must return the original hard copy of your license and submit a copy of supporting documents. Supporting documents include:
- Marriage certificate
- Divorce decree
- Court documents
- Other documentation
Fees for Request a name change, address change, or a duplicate license for respiratory therapists
For duplicate licenses:
- You must pay the duplicate license fee for each license you wish to have duplicated
There are no fees for:
- Address changes
- Name changes with renewal
Pay by check or money order, payable to the Commonwealth of Massachusetts
- Don't send cash or electronic funds transfers
| Name | Fee | Unit |
|---|---|---|
| Duplicate license | $17 | per license |
| Name change with new license | $27 | per license |
How to request Request a name change, address change, or a duplicate license for respiratory therapists
- Download and complete the application, found below
- Attach all documentation and fees
- Mail to:
Board of Respiratory Care
250 Washington Street
Boston, MA 02108
Please note: name changes must be submitted via mail with applicable attachments
For requesting address changes and/or duplicate licenses, you can login to our Online Licensing portal.
More info for Request a name change, address change, or a duplicate license for respiratory therapists
- If you are requesting a name change and you have a current or expired license with another board within the Bureau, the requested name change will be effective for all boards
- All addresses are subject to disclosure on request (MGL c. 4, s. 7)
Downloads for Request a name change, address change, or a duplicate license for respiratory therapists
Contact for Request a name change, address change, or a duplicate license for respiratory therapists
Address
250 Washington Street, Boston, MA 02108
Phone
Fax
(617) 973-0980