An official website of the State of Georgia government.
Here’s how you know
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.
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 General Information and Checklist
Reinstatement Application Form
FORM A - Affidavit of Applicant
FORM A2 - Affidavit of Citizenship Status
FORM B - Request for Additional Duties
FORM C - Anesthesia Reference Form
FORM D - Primary Care Reference Form
FORM E - Anesthesia Job Description
FORM F - Primary Care Job Description
FORM I - Verification of Licensure