Genetic Counselor

(Checklist and Forms at bottom of page)

Please read these instructions and the laws/rules governing the practice of Genetic Counselors before completing your application.

There are two types of Genetic Counselor licenses:

  • Full License
  • Temporary License
    Applicants are only eligible for a temporary license if they have been granted an active candidate status by the ABGC. An applicant who is applying for a temporary license must take and pass the examination for certification within eighteen (18) months of the issuance of the temporary license and may only practice if he or she has entered into a genetic supervision contract and is already supervised by a licensed genetic counselor or a licensed physician. A temporary license will expire thirty (30) days after failing to pass the complete certification examination.

All applications are good for one-year only from date of receipt.

APPLICATIONS WILL NOT BE REVIEWED WITHOUT APPLICATION FEE.  

APPLICATION PROCESSING
It is important to make sure to include your application fee at the time you submit your application.  Staff cannot begin the initial review of your application without the fee.  Within 10 business days after receipt of your application, a status letter will follow identifying outstanding documentation, if any, to make your file complete.  Submit all required documentation as soon as possible.  It is recommended that applicants wait 15 business days, after submitting their application, or until receipt of a deficiency letter, to contact the staff by phone regarding the status of their application.  It is imperative for applicants to understand that the review process is guided by the requirements set forth in State law, which does not provide for any waivers to be granted by staff. 

BOARD MEETINGS
In order for an application to go before the Medical Board for approval, it must be received as completed 10 business days before the next scheduled board meeting. Completion of an application is when all primary source documentation has been received and reviewed, your application has met all administrative screenings, a final quality assurance review has been completed on your application, and you have been advised in writing from the Board.

INTERNET DISCLOSURE OF GENETIC COUNSELOR ADDRESS
Georgia law requires the Georgia Composite Medical Board to provide, upon written or verbal request, an address for each licensed Genetic Counselor.  Public-record information pertaining to licensed Genetic Counselor is available to the public through the Board’s website.

The release of this information has highlighted the need for individuals to carefully consider the address they provide to the Board as their address of record.  The address you indicate as your address of record will be the address disclosed to all individuals making inquiries and will be utilized to mail all licenses, renewal notices, and other official correspondence from the Board. 

You may choose your home address or your office address to be your address of record.  If you list a P.O. Box as your primary address, you must also provide a secondary street address that will remain confidential.  Georgia law requires that the Board be kept informed of any changes of address.  Changes should be submitted in writing to the above address, and should include the license number, name, old address and new address.

 

CHECKLIST FOR GENETIC COUNSELORS

This checklist is intended to assist you with the filing of a complete application.  Read all instructions on each page carefully and utilize the checklist as you are filling out the application.  All items listed that apply to your situation must be submitted in order for your qualifications for licensure to be assessed.  When submitting copies of documents, please ensure they are 8-1/2 x11-inch copies of the original. All supporting documentation should be uploaded into online portal when submitting an application.

  • Application
  • Application Fee
  • Affidavit of Applicant
  • Citizenship Affidavit
  • CV / Resume
  • American Board of Genetic Counseling (ABGC) or the American Board of Medical Genetics (ABMG) Verification
  • Reference Form
  • State Board License Verification (not required of all applicants)
  • National Practitioner Data Bank Self-Query (not required of all applicants)
  • Specific Power of Attorney Form (optional)

---

Genetic Counselor Forms

  • Genetic Counselor Online Application

    All applications should be submitted through the Board's online portal.  Answer all questions honestly and thoroughly.  If an answer requires an explanation or additional supporting documentation (court records, etc.), it can be uploaded via the online portal.

  • Application Fee

    Applicants can pay via the online portal with a credit or debit card.

  • Affidavit of Applicant (PDF, 53.7 KB)

    Read this form in its entirety and complete all areas.  A current passport photo is required to complete this form.  Do not submit photos from digital reproductions, magazine, yearbook, wedding, birthday, family outing, etc.  Take this form to a notary public for witness of your signature.  The applicant’s signature date and the notary signature date must match.  No whiteouts or strikeouts are accepted.

  • Citizenship Affidavit (PDF, 720.33 KB)

    Take this form to a notary public for witness of your signature.  The applicant’s signature date and the notary signature date must match.  No whiteouts or strikeouts are accepted.

    If you are a U.S. Citizen, you may submit a copy of your U.S. passport, driver’s license, or birth certificate.

    If you are not a U.S. citizen, you must submit documentation that will determine if you have a qualified alien status.  Only those applicants who can provide proof will be granted a license.   The Board participates in the DHS-USCIS SAVE (Systematic Alien Verification for Entitlements or "SAVE") program for the purpose of verifying citizenship and immigration status information of non-citizens. 

    In order to confirm your status with the SAVE program, you need to provide the board with legible copies of one of the verifiable documents listed.  Use a good quality copier and increase the size of the copy if need be. If the following information is needed, it must be legible: Alien Number; Card Number; Document Expiration Date; SEVIS ID Number.  One or all of these numbers or dates may be required when we submit your information to SAVE.  If we cannot read what you have submitted, we will be unable to submit your information to the SAVE program, which will delay the consideration of your application.

  • American Board of Genetic Counseling (ABGC) or the American Board of Medical Ge… (PDF, 22.77 KB)

    Please visit the website to submit a request that your verification be sent to the GCMB.

  • Reference Form (PDF, 58.5 KB)

    In order for the Board to adequately evaluate the applicant to practice as a Genetic Counselor in the State of Georgia, a reference form is required. This reference form must be completed and signed by a supervisor with whom the applicant practices with at the time of application. An original signature is required.  This form must be emailed directly from the supervisor with whom the applicant practices with at the time of application to the Georgia Composite Medical Board.

    This form can be scanned and emailed directly from the supervisor with whom the applicant practices with at the time of application to the Georgia Composite Medical Board at the email address below.  Emails must come from a practice or hospital email address of the person completing the reference form.  NO personal email accounts (Gmail, Yahoo!, etc.).

  • National Practitioner Data Bank Self-Query

    This data bank is mandated by Congress to track regulatory Board disciplinary actions and certain actions resulting from peer review and malpractice payments.

    Applicants who have held a license in any jurisdiction (Georgia or other states) must self-query the NPDB on your own as part of the application process for a Georgia license.  Click the link above to begin the query the process.  When you receive the response, upload a copy along with your application packet.

    If an applicant has never held a license before (in any jurisdiction), the NPDB self-query is not required.

  • State Board License Verification (PDF, 54.49 KB)

    Complete the top portion of this form and send it to each state board in which you are now or have ever been certified or licensed.  The verification must come directly from the state. Original official, certified verifications of license history of all medical licenses you have held or currently hold is required for each permanent, temporary, training, provisional or limited license held, even if you have not worked in that state or in any state in the US or Canadian territory or province, and US federal jurisdiction for 20 years, or you got a license and never practiced in that state.  List the State/Country, dates of licensure, licensed by examination, reciprocity, state board examination.

    If an applicant has never held a license before (in any jurisdiction), the State Board License Verification is not required.

  • Specific Power of Attorney Form (PDF, 149.06 KB)

    OPTIONAL.  Applications are confidential pursuant to State law.  Therefore, permission must be granted by an applicant before the Board can give any updates to a third party.  Please inform all hospitals, employers, recruiters, referral companies, family members, or insurance companies that application status updates will not be provided unless a Specific Power of Attorney Form is included with the application packet.  The Specific Power of Attorney Form must be signed and notarized in order to be accepted by the Board.

  • Genetic Counselor Rules Chapter 360-39
  • Inactive Status Request - v 11/2022 (PDF, 136.9 KB)
  • Separation Notice Form (PDF, 26.8 KB)

Contact

Licensure Specialist Dwana Robinson

Contact for Physician applicants (with last names D - I) and Genetic Counselor applicants

[email protected]
Primary
(470) 692-4172