Applications/registrations - physician assistants

Both a license and registration to a supervising physician are necessary to practice as a physician assistant in Alabama.

An initial P.A. license and registration may be obtained at the same time.  While licensing is a "one time thing," registration is required for each new professional relationship.

Before beginning to complete the forms, you should thoroughly read Board Rules, Chapter 540-X-7, Assistants to Physicians.

It is the responsibility of the supervising physician and the PA/AA to submit an application in a timely manner (based on the Board’s established schedule).  Click here for agenda deadline schedules.  

Interim approval for registration agreements will not be provided to a PA until after four weeks of receipt. The Board staff requires four to six weeks to process an initial application and registration agreement.   

Due to the volume of applications received, the Board staff will not offer any exceptions.

A license or registration application will not be placed on the agenda until the application is complete by the agenda deadline (not postmarked), including receipt by the Board of all supporting documentation. 

Note:  Please be reminded that waiting to receive information from other agencies can cause delays in a licensure application being placed on the Board's agenda, i.e., license verification from other states, criminal background results.

The forms provided here must be used for your application.  You can print this page and use it as a checklist.

You should keep a copy for your records of all applications submitted

NOTE: you may need to refresh the page (F5) to see the latest forms

Step 1 - Licensure

The application for a P. A. license contains the following forms:

  • Application for P. A. license (6 pages)
  • Appendix - verification of other state licenses (1 page)
  • ☐ Fingerprint cards for criminal background check 
    •    Please note: fingerprint cards must be mailed to you; please request the cards and instructions and provide your mailing address to

A complete license application will contain all of the following:

  • ☐ Complete and notarized application and appropriate attachments.
  • ☐ Current color photograph.
  • ☐ Separate response/document(s) for questions answered "yes" and calls for other documentation.
  • ☐ Copy of diploma(s) reflecting graduation from approved P. A. training program
  • ☐ Copy of current NCCPA certificate or original NCCPA certification of successful completion of the examination.
  • ☐ Declaration of Citizenship with supporting document
  • ☐ Verification(s) received directly from other state(s) licensed.  P.A. should send form(s) to other state(s)
  • ☐ Check for $200 to Alabama Board of Medical Examiners.
  • ☐ Documentation for Criminal History Background Check (ABI-46), including completed fingerprint cards.
    •    Please note: fingerprint cards must be requested and mailed to you; please email the with your request and mailing address. Instructions for obtaining fingerprints (ABI-46) will be included.
  • ☐ Check for $65.00 to AL Board of Medical Examiners for criminal history background check. (Separate check).

Step 2 - Registration

Before being approved to practice, a formal work relationship with a supervising physician is established by approved registration to a physician.

The application packet for registration of a P. A. to a supervising physician contains the following forms:

  • Registration Agreement Packet
  • ☐ Application for registration of P. A. (3 pages)
  • ☐ Supplemental certificate of hospital/employer (if applicable) (2 pages)
  • ☐ Reference info - prescription guidelines for P.A.s (for physician/P.A. to keep) (2 pages)
  • ☐ Formulary for non-controlled prescribing (2 pages)
  • ☐ Covering physician certification (1 page)
  • ☐ Skill requirements for initial certification (1 page)

A complete application for registration will include:

  • ☐ Application for registration (required)
    • Review questions #3, #4, and #5 and answer each question completely
  • ☐ Supplemental certificate of hospital/employer (if applicable).
    •     If the P. A. is to be employed by a hospital, clinic or entity that also employs the supervising physician, or the assistant works for one entity and the physician another, the supplemental certificate is required.
  • ☐ Approved Formulary (if applicable).
    •     Required if non-controlled prescribing privileges are authorized. Mark “yes” only to those categories which are generally used in the physician’s particular specialty. A request for others not listed on the formulary must be accompanied by written explanation from the physician. Not required for recent graduates seeking or currently having a temporary license as they are not eligible for prescriptive privileges.
      Note: controlled prescribing privileges are granted through a QACSC application after licensure and registration are complete.  There are certain criteria that must be met before applying for a QACSC.  Please see Board Rules Chapter 540-X-12 for the Board's Administrative Rules concerning QACSCs for P.A.s.
  • ☐ Model “covering physician” letter (if applicable). It is not required to have a covering physician, but if there is none, the P. A. may only practice when the supervising physician is readily available.
  • ☐ A check for $100 payable to the Alabama Board of Medical Examiners. Your printed name must be included in the memo section, if you are not submitting a personal check.

Application verification

To renew the status of an application, click here:

Board staff requires four to six weeks to process an initial application and/or registration agreement.  Before checking on the status of an application, be sure that four to six weeks have passed from the date that the application was submitted. 

For an initial application, select “PA” for License Type

For a registration agreement, select “RA” for License Type

         To review the Board’s decision regarding an approved initial application and/or registration agreement, click here.

Allow three business days after the Board meeting to verify the status of a submitted application

Click here for agenda deadline schedules

Termination of registration

  • The physician assistant and the physician are responsible for informing the Board of the effective date of the termination of employment and the reasons for such termination.
  • Failure to notify the Board of termination may be considered by the Board as a violation of Board rules for the purpose of approval of future applications for registration.
  • Termination must be in writing and can be accomplished using the online P. A. registration termination form.

Click here for QACSC information

Copyright 2018 The Alabama Board of Medical Examiners
All rights reserved