Department of Health


DOH HOME

DC BOARD OF MEDICINE - PHYSICIAN ASSISTANTS
Application Package
Regulations
Contact Information
Disclaimer

SERVICES
Health Professional
  Licensing Administration


INFORMATION

ONLINE SERVICE
  REQUESTS






Advisory Committee on Physician Assistants
Untitled
The applications package for the Advisory Committee on Physician Assistants must include all documents listed in the chart below. The Board reviews each application package and determines an applicant's eligibility for a license. There are two different types of forms: online application forms and printable forms. Please follow the instructions for each and include all forms in the application package in hard copy format.
  • Online Application: At this time, only the application form may be filled out online. However, the form cannot be submitted electronically; you must include a printed version with the other items listed in the chart to complete the application package. Fill in the information online, print the form, sign it, and mail it with the rest of your items.


  • Printable Forms: Print the form, fill it out, sign it, and include it with the application package.
Specific instructions are provided within each form below.

 Application Package Documents Form Types
  Online Printed
New License Application X X
Clean Hands Form * X
Character Reference Form * X
Certification Form * X
Authorization for Release of Information * X

 Application Information Documents
Municipal Advisory Committee on Physician Assistants - DCMR Chap 49 *
Municipal Health Occupations General Rules - DCMR Chap 40 *
Municipal Health Occupations Administrative Procedures - DCMR Chap 41 *
Application Check List *
Standard Job Description for Physician Assistant *
Advanced Job Description*



* This document is presented in Portable Document Format (PDF). A PDF reader is required for viewing.
Download a PDF Reader or Learn More About PDFs