An official website of the State of Georgia.
The .gov means it’s official.
Local, state, and federal government websites often end in .gov. State of Georgia government websites and email systems use “georgia.gov” or “ga.gov” at the end of the address. Before sharing sensitive or personal information, make sure you’re on an official state website.
Still not sure?
Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia.
When making application for reinstatement of your Physician Assistant (including Anesthesia Assistant) license, please utilize the following forms:
Reinstatement of AA/PA Licensure Application- General Information and Checklist (PDF, 291.05 KB)
Reinstatement Application Form (PDF, 310.39 KB)
FORM A - Affidavit of Applicant (PDF, 100.92 KB)
FORM B - Request for Additional Duties (PDF, 180.52 KB)
FORM C - Anesthesia Reference Form (PDF, 50.2 KB)
FORM D - Primary Care Reference Form (PDF, 93.04 KB)
FORM E - Anesthesia Job Description (PDF, 166.14 KB)
FORM F - Primary Care Job Description (PDF, 153.57 KB)
FORM I - Verification of Licensure (PDF, 42.53 KB)