State Medical Board

Applications & Forms

Please click on the links under the categories below for available licensing forms. All forms may be viewed and printed with the free Adobe Acrobat Reader 6.0 or higher.

Initial Applications

 

Renewal Applications

Online renewal for Physicians, Osteopaths and Podiatrists is now available.

Click Here to Renew Online!

If you prefer to submit a paper application, or if you are unable to renew online, you may download the application using the links below.

Paramedic and Physician Assistant renewal forms for the January 1, 2015 through December 31, 2016 licensing period will be mailed and be available online approximately 30 days before the December 31, 2014 expiration date of your license. Please ensure that the division has your correct address on file.

Prior year renewal applications are not valid for other renewal years.

If you need to reinstate a lapsed license, please contact the Division at (907) 465-2541 or 465-2550.

 

Miscellaneous Forms