Applications/registrations - physician assistants and anesthesiologist assistants

Both a license and registration to a supervising physician are necessary to practice as an assistant to a physician 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 (click "Chapter 540-X-7, Assistants to Physicians").

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

The Board staff requires four to six weeks to process an initial application and initial registration agreement.  Click here to determine if interim approval is issued by the Board. 

For additional information regarding interim approval, thoroughly read Board Rules, Chapter 540-X-7, Assistants to Physicians (click "Chapter 540-X-7, Assistants to Physicians"). 

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.


Application verification
 

To review the status of an application, click here: https://abme.igovsolution.com/online/Lookups/Application_StatusCheck.aspx

Board staff requires four to six weeks to process an initial application and/or initial registration agreement.  

For an initial application, select “P.A." or "A.A." for License Type

For temporary P.A. application, select "TA" for License Type

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

To review the Board’s decision regarding an approved initial application and/or registration agreement, click here: https://abme.igovsolution.com/online/Lookups/Individual_Lookup.aspx

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

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


PHYSICIAN ASSISTANTS (P.A.)

To ensure the Board reviews your application in a timely manner, do not reformat the required forms located on this page.  Forms that are reformatted will not be accepted and will be returned to the applicant.

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)
  • ☐ Payment of $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.
  • ☐ Payment of $65.00 to AL Board of Medical Examiners for criminal history background 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:

 

If you're requesting additional skills:


  • 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.
        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.
    • ☐ Payment of $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. (required)


  • ANESTHESIOLOGIST ASSISTANTS (A.A.)

    To ensure the Board reviews your application in a timely manner, do not reformat the required forms located on this page.  Forms that are reformatted will not be accepted and will be returned to the applicant.

    Step 1 - Licensure

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

    • Application for A.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 A. A. training program
    • ☐ Copy of current NCCAA certificate or original NCCAA certification of successful completion of the examination.
    • ☐ Declaration of Citizenship with supporting document
    • ☐ Verification(s) received directly from other state(s) licensed.  A.A. should send form(s) to other state(s)
    • ☐ Payment of $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 will be included.
    • ☐ Payment of $65.00 to AL Board of Medical Examiners for criminal history background check.


    Step 2 - Registration

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

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

    • Registration Agreement Packet
    • ☐ Application for registration of A. A. (2 pages)
    • ☐ Supplemental certificate of hospital/employer (if applicable) (2 pages)
    • ☐ Covering anesthesiologist certification (1 page)
    •  Skill protocol template (1 page)
      Additional skills requested outside the core duties of the P.A. (i.e. diagnostic or surgical procedures requiring additional training) must be individually considered and approved by the Board before performing them

    A complete application for registration will include:

    • ☐ Application for registration (required)
      • Review questions #11 and #12 and answer each question completely
    • ☐ Supplemental certificate of hospital/employer (if applicable).
      •  If the A. 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.
    • ☐ Model “covering physician” letter (if applicable).
    • Skill protocol template
      • Additional skills must be individually considered and approved by the Board before performing them
    • ☐ Payment of $100 payable to the Alabama Board of Medical Examiners. Your printed name must be included in the memo section of a submitted check. (required)


    Termination of registration

    • The P.A./A.A. 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./A.A. registration termination form.

    Click here for QACSC information

    Copyright 2018 The Alabama Board of Medical Examiners
    All rights reserved