Cosmetic Laser Practitioner (Senior and Assistant)

Please use the online portal only to submit your application and documents. Physically mailed documents will not be accepted.

  • Click HERE to submit a Assistant Cosmetic Laser Practitioner License Online Application

    • HOW TO SUBMIT: The Board no longer accepts paper applications.  All applications should be submitted through the Board's online portal
    •  Answer all questions honestly and thoroughly
    • Some “Yes” responses require statements of the circumstances surrounding the event and relevant documentation to the situation.  If an answer requires an explanation or additional supporting documentation (court records, board actions, etc.), it can be uploaded via the online portal.

  • Click HERE for Application Fee Information

    • HOW TO PAY: All applicants can pay via the online portal with a credit or debit card at the time of application submission. Checks and/or money orders are no longer accepted.
    • This link is to the Board's fee schedule
    • There are two transactions for all credit/debit card payments.  The first charge is the payment to the Board for whatever the fee is.  The second charge is a 3.15% processing fee for running the card, which is kept by the processor.

  • CV / Resume

    • HOW TO SUBMIT: Upload this document into the online account at the time of application submission.  If you have already submitted the application, this can be submitted to GCMB Requests Portal NextRequest - Modern FOIA & Public Records Request Software with the applicant's name in the Subject Line.
    • Ensure chronological progression of clinical practice, education, employment, and explanations for any time gaps
    • Be sure to include date(s) last practiced clinical medicine

  • Download this pdf file. Click HERE for the Affidavit of Applicant

    • Step 1: Document Review and Completion
      • Thoroughly read and complete all sections of the form.
    • Step 2: Passport Photo Requirements
      • Attach a current passport photo to the form.
      • Ensure the photo is a color copy for clarity.
      • Do not use photos from digital reproductions or personal events (e.g., weddings, birthdays).
    • Step 3: Document Submission
    • Step 4: Signature and Notarization
      • Confirm that the applicant’s signature date matches the notary signature date.
    • Step 5: Notary Compliance
      • The Board accepts notary stamps that comply with the laws of the state of origin.
      • For Georgia: In-person notarization is required.
      • For other states: Online notarization is acceptable if it’s legal in that state (e.g., Virginia).
    • Note: 
      • Whiteouts or strikeouts on the form are not accepted.
      • The form must be signed by the applicant and notarized.
      • Ensure the notary seal is clear and recognizable on the scanned PDF.

  • Download this pdf file. Click HERE for the Citizenship Affidavit

    • Step 1: Prepare Your Documents
      • For the Citizenship Affidavit, download the PDF file from the provided link.
      • For US Citizens: Prepare a clear, legible copy of your Driver’s License or Passport.
      • For Non-U.S. Citizens: Prepare a clear, legible copy of your qualified alien status documents (e.g., Permanent Resident Card, SEVIS document).
    • Note: Use only one document for proof.
      • Avoid using Birth Certificates for US Citizens and Driver’s Licenses for Non-U.S. Citizens as they are not acceptable forms of proof.
    • Step 2: Ensure Document Compliance
      • Ensure the applicant’s signature date matches the notary signature date.
      • Verify that the notary seal is clear and recognizable when scanned as a PDF.
      • Note that no whiteouts or strikeouts are accepted on the affidavit.
    • Step 3: Submit Your Documents
    • Step 4: Notarization
      • The affidavit must be signed by the applicant and notarized.
      • The Board accepts notary stamps that comply with the laws of the originating jurisdiction.
        • For Georgia: In-person notarization is required.
        • For other states: Remote notarization is acceptable if permitted by local laws (e.g., Virginia).
    • Step 5: Verification with SAVE Program
      • Provide legible copies of documents for verification with the DHS-USCIS SAVE program.
      • Ensure legibility of crucial information such as Alien Number, Card Number, Document Expiration Date, and SEVIS ID Number.
      • Incomplete or illegible information may delay the application process.

  • Laser Training Certificates

    • HOW TO SUBMIT: Upload this document into the online account at the time of application submission.  If you have already submitted the application, this can be submitted to GCMB Requests Portal NextRequest - Modern FOIA & Public Records Request Software with the applicant's name in the Subject Line.
    • SENIOR applicants must submit TWO certificates
    •  ASSISTANT applicants must submit THREE certificates
    • Courses must be taught by a Physician or an ACCME-certified educator
    • Certificates must be signed by the Physician or an ACCME-certified educator that taught the course

  • Download this pdf file. Clinical Medical Experience and Consulting Physician Agreement Forms

    • Step 1: Document Preparation
      • Download the Clinical Medical Experience Form from the provided link.
      • For SENIOR Cosmetic Laser Applicants: Ensure the form reflects at least three years of clinical/medical experience. If needed, use multiple copies to cover all relevant experience.
    • Step 2: Consulting Physician Agreement
      • Download the Consulting Physician Agreement Form from the provided link.
      • This form must be completed in full and signed by both the consulting physician and the applicant.
    • Step 3: Submit Your Documents
      • If you are in the process of applying, upload both completed forms into your online account at the time of application submission.
      • If your application has already been submitted, submit the forms to GCMB Requests Portal NextRequest - Modern FOIA & Public Records Request Software with the applicant’s name in the Subject Line.
      • Note: These steps are applicable only to SENIOR Cosmetic Laser Applicants.


Helpful Links 

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For questions about your pending application for Cosmetic Laser Practitioner licensure, contact our specialist at:

GCMB Requests Portal NextRequest - Modern FOIA & Public Records Request Software

Contact

Licensure Specialist Ernest Huddleston

Contact for Resident Training Physician/ Laser Practitioner / Orthotist / Prosthetist applicants

NextRequest