New Grad Physician Assistant: Required Forms and General Information

PLEASE CLICK HERE FOR SIMPLE CHECKLIST FOR NEW GRAD PA/AA APPLICATION
 

Here is the method you should submit your application:

Our Egov Portal: New Grad License Application

APPLICATIONS WILL NOT BE REVIEWED WITHOUT APPLICATION FEE OF $300.00

AVAILABLE FORMS TO DOWNLOAD (YOU MAY NOT NEED ALL OF THESE, REFER TO CHECKLIST)

FORM A - Affidavit of Applicant

FORM A2 - Citizenship Affidavit

FORM B - Request for Additional Duties

FORM C - Anesthesia Reference

FORM D - Primary Care Reference

FORM E - Anesthesia Basic Job Description

FORM F - Primary Care Basic Job Description

FORM H - SEPARATION NOTIFICATION

FORM I - Verification of Other State License

FORM J - Specific Power of Attorney

FORM K - Certificate of Education

PA/AA Utilization Form