Get Initial Physician Assistant Application - Georgia Composite Medical ... - Medicalboard Georgia

The Initial Physician Assistant Application is a crucial step in obtaining a license to practice as a physician assistant in Georgia. This guide provides clear and supportive instructions on how to complete the application online, ensuring that you navigate each section with confidence.

Follow the steps to successfully complete your application online.

1. Press the ‘Get Form’ button to retrieve the application form. This will allow you to access it in your preferred online editor.
2. Begin by filling out your name and personal details. Ensure accuracy in your social security number, last name, first name, middle name, and any other surnames. Indicate your gender and birth date.
3. Provide your contact details. Enter your mailing address, including street number, street name, city, state, and zip code. Include your area code and phone number. Also, provide a valid email address, as this will be used for communications.
4. Complete the practice location section. Enter the street number, street name, city, state, and zip code of your practice location. This information will be posted on the Internet once your license is issued.
5. Answer the Physician Assistant applicant questionnaire. For each question, check 'yes' or 'no'. If you answer 'yes' to any question, you are required to attach detailed documentation related to that question.
6. Fill out your license history, listing all states where you have been licensed to practice as a PA. Include the state, date licensed from, date licensed to, license number, and licensure status (active/inactive).
7. Provide your college education information. List the college name, location, date of attendance, and graduation date.
8. Complete the utilization section of the form, providing information about your supervising physician, including their name, license number, address, specialty, and business phone.
9. Review all entered information for accuracy. Ensure all required fields are filled correctly and all necessary documents are attached.
10. Once you are satisfied with your application, save your changes. You can then download, print, or share the completed form as needed.

Take the next step in your career by completing your Initial Physician Assistant Application online today!