DOH Service Telephone Directory
Select directory to view the telephones number of the various DOH services.
Physician Assistants Initial License Application Package
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.
Specific instructions are provided within each form below.
Application Package Documents
New License Application [PDF]
Character Reference Form [PDF]
Certification Form [PDF]
Authorization for Release of Information [PDF]
Application Information Documents
Application Instructions [PDF]
Application Check List [PDF]
Delegation Agreement for Physician Assistant [PDF]
Criminal Background Check






