Here are the steps to notify the Board of a change to your legal name
- This page, Submit a Name Change Application, is offered by
- Board of Registration in Medicine
Submit a Name Change Application
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The Details of Submit a Name Change Application
What you need to know for Submit a Name Change Application
The Board of Registration in Medicine publishes an online profile for all Massachusetts Full Physician Licensees, available at FindMyDoctor.mass.gov.
Physicians are responsible for updating key sections of their profile, including a change to your legal name.
If you are renewing your license, we recommend completing the name change first. Alternatively, you can notify the Board of a name change after, but not during, the renewal process.
Required Documentation
You must submit photocopies of the following two required documents:
- A current government issued photographic identification (e.g., driver license, passport, etc.); AND
- One of the following additional legal documents as proof of name change:
- Certified Court Order
- Marriage Certificate
- Divorce Decree
How to submit Submit a Name Change Application
To submit a name change application, you must already have a user account and link your account to your license. The video tutorials below (each less than 90 seconds in duration) will provide you with step-by-step instructions to assist you in creating an account and linking your account to your license.
After logging in to your account, select "Manage My Licenses and Applications", then "Show Details", and then "Submit a Name Change Application", and the following will happen when completing this application:
- You will be redirected to a confirmation page on this site – please print this page or save a screenshot for your records before submitting;
- You will receive a confirmation email with your application number affirming the submission; and
- Your application will enter the review queue.
After you submit your application, you may log in and view it in your account, but you cannot make edits unless the Board gives permission for changes. That may happen if the reviewer has questions or needs more information.
You will be notified via email when the Board has processed your name change application. A new License Certificate and/or Wallet Card will be emailed to you and will also be available for you to download from the website.
Please call the BORIM call center at 781-876-8230 if you have any questions.
More Info for Submit a Name Change Application
Manage Your Account for Submit a Name Change Application
You can check your application status, receive notifications, and update your contact information with your License Management System account.
Contact for Submit a Name Change Application
Address
Phone
For status updates on pending applications