Cosmetic Laser Practitioner (Senior and Assistant)

• Online‑only process: All applications and supporting documents must be submitted through the Board’s online portal. Paper or mailed items are not accepted.
• Start your application:

  • Assistant Cosmetic Laser Practitioner – [Apply Online]

• Answer truthfully: Complete every question. “Yes” responses require a short statement and relevant court/board documents uploaded with the application.

• Fee schedule: See [Board Fee Schedule] for current amounts.
• Pay online at checkout with a credit or debit card.
  • Two charges will appear: the Board fee and a 3.15 % card‑processing fee retained by the processor.

• Best practice: Upload all required documents during the initial EGov application.
• After submission: If you need to add or replace a document, submit it via NextRequest with the applicant’s name in the clearly labeled.

CV / Resume

• Chronological order of clinical practice, education, and employment.
• Explain any gaps and include the date last practiced clinical medicine.

Affidavit of Applicant (with passport photo)

1. Download & complete every section of the form.
2. Attach a current color passport photo (no event photos, no photocopies).
3. Sign & notarize: Applicant and notary must sign on the same date.
   • Georgia: in‑person notarization required.
   • Other states: remote notarization allowed if legal there (e.g., Virginia).
4. No alterations (white‑outs or strike‑outs). Ensure the notary seal is clear on the scan.

Citizenship Affidavit

1. Prepare one acceptable proof document:
   • US citizens: Driver’s License or Passport (no birth certificates).
   • Non‑US citizens: Permanent Resident Card, SEVIS, or other qualified alien document.
2. Sign & notarize as in 4.2 (same‑day signatures, clear seal).
3. Upload legible copies so the DHS‑USCIS SAVE program can verify Alien #, Card #, expiration date, or SEVIS ID.

Laser Training Certificates

• Senior applicants: TWO certificates.
• Assistant applicants: THREE certificates.
• Each course must be taught by a physician or ACCME‑certified educator, and the certificate must be signed by that instructor.

Clinical Medical Experience Form & Consulting Physician Agreement ( Senior only )

1. Clinical Medical Experience Form: Show ≥ 3 years of clinical/medical experience (use extra pages if needed).
2. Consulting Physician Agreement: Complete, then sign with the consulting physician.