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 Physician License
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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