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Georgia Composite Medical Board

Georgia Composite
Medical Board

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  • About the Board
    • Purpose and Mission Statement
    • Message from the Board Chairperson
    • List of Board Members
    • GCMB Executive Director & Staff
    • Calendar & Agenda of Board Meetings
    • View the Board's Annual Report
    • Contact Us
    • Directions to the Office
    • Monthly Board Minutes
    • List of Monthly Public Board Orders
    • Active License Count
    • Links for Consumers and Practitioners
  • Consumer Resources
    • Frequently Asked Questions for Consumers
    • How to File a Complaint
    • Look up a Licensed Provider
    • Obtain Public Board Orders
    • Open records request
    • Directions to the Office
    • Tips on Choosing a Doctor
    • Order GCMB Licensure Database
    • Contact the Board
  • Professional Resources
    • When You Apply
    • Renew or Apply Online
    • Applications Center
    • Frequently Asked Questions
    • Duplicate ID Request
    • License Certification - All Professions
    • List of APRN Protocols Reviewed by the Board
    • How to file a complaint
    • Malpractice Reporting Form
    • Wellness Information
  • GCMB Online Services
  • Look Up a Licensee
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    • Rules
    • Petition and Waiver
    • Notice of Intent to Amend, Adopt Rules
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  • Press Releases

Professional Resources

  • When You Apply
  • Renew or Apply Online
  • Applications Center
    • Acupuncturist
    • Auricular Ear Detoxification Technician
    • Clinical Perfusionist
    • Physician
      • Application Forms
      • Frequently Asked Questions
      • Physician Profile Information and Forms
    • Physician Assistant (including Anesthesiologist Asst)
    • Resident Training Physician
    • Respiratory Care Professional
    • Orthotist and Prosthetist
    • Pain Managment Clinic Registration
    • Vaccine Protocol Registration
    • NP Protocol Registration Forms
    • Cosmetic Laser Practitioner's Applications
  • Frequently Asked Questions
  • Duplicate ID Request
  • License Certification - All Professions
  • List of APRN Protocols Reviewed by the Board
  • How to file a complaint
  • Malpractice Reporting Form
  • Wellness Information
Home » Professional Resources » Applications Center » Physician » Application Forms

Application Forms

Form A, Certificate of Postgraduate Training

Form B, Reference Form

Form D, Affidavit of Applicant

Form D2, Affidavit of Citizenship

Form E, Malpractice Questionnaire

Form G, Specific Power of Attorney

Form H, Request for Temporary License
   (NOTE: Do not use Form H unless your Applications Specialist has told you are eligible)

License History Addendum

 

Other Physician Application Pages

Initial Physician Licensure
Institutional Physician Licensure
Educational Training Certificate Application Form
Physician Teacher Licensure
Volunteer In Medicine
Inactive Status Application
Physician Reinstatement Application
Physician Wall Certificates
Physician Licensing Rules Chapter 360
Physician Licensing Exams-Information and Links
Federation Credentials Verification Service (FCVS)

Service offered by the Federation of State Medical Boards (FSMB) in the applications process.

Initial Licensure Requirements for US, International & 5th Pathway
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