Malpractice Reporting Form and submission requirements

Pursuant to O.C.G.A. § 33-3-27, licensees must report each malpractice claim to the Board within 10 days of payment, judgment, or agreement of the parties.

The form and additional information should be submitted via NextRequest. 

Please select Compliance as the department for your submission.

Link to Form: 

Georgia_Malpractice_Claim_Report_Fillable.pdf  (PDF, 495.45 KB)

A tutorial for submitting a NextRequest ticket can be found here: NextRequest Tutorial