Application & Instructions for Initial Licensure - Physician Assistant

Log in to LaMED DashBoard to begin a new online initial application, complete a previously started (and saved) online initial application or to check the status of your completed online initial application.

To access a paper application, click HERE (available for a limited time)

The items listed below MUST be completed and mailed to the LSBME as part of the initial application process.

Note: notarized documents must be signed in the presence of a notary.

Oath or Affirmation
This form must be notarized. All yes answers must be accompanied by a sworn affidavit. A sworn affidavit is an explanation (in applicant’s own words) that must be typed and notarized. Note: If criminal history is found that was not disclosed, you will be required to submit a new Oath or Affirmation, a notarized affidavit as to why you did not disclose the information and a new processing fee equal to the initial licensure fee. It is important that you answer question 3 accurately and truthfully. Do not take the advice of friends, lawyer, etc.

Third Party Authorization
This form must be notarized. It authorizes LSBME to obtain information concerning the applicant from third parties.

Photograph
A passport quality photograph must be submitted.  This photo must be a 2"x2" clear, head and shoulders photo taken within the last 6 months.

FCVS
You must complete the FCVS application in order to apply for licensure.

Background Check
LSBME conducts background checks as part of the application process. Instructions and forms can be found at the link above.

Additional Requirements

Fee
Licensure:  $275.00.

Fee must be paid via credit/debit card (Visa, MasterCard or Discover only) if applying online.
Fee must be paid via Personal check/money order if sending in a paper application.
Fee is non-refundable.

Birth Certificate/Valid Visa

  • U.S. born citizen - submit a notarized copy of birth certificate

  • U.S. citizen not U.S. born - submit notarized copy of proof of citizenship (ie certificate of citizenship or consular report of birth abroad). Naturalized citizen - submit a notarized copy of birth certificate and notarized Certificate of Naturalization.

  • Non U.S. citizen - submit a notarized copy of birth certificate and notarized current Visa issued by the U.S. Citizenship and Immigration Services. (Acceptable Visas: H1B, J1, O1, NAFTA-TN or Employment  Authorization, or Permanent Resident)

Marriage Certificate/Name Change
Application for certification in a name other than what appears on the birth certificate requires a notarized copy of official documentation of name change (ie marriage certificate).

Notarization as a “True Copy”
   Request the notary to certify a copy of your birth certificate and/or marriage certificate as a “true and correct copy of the original”. If the notary will not notarize the copy,
   you can attest that it is a “true and correct copy of the original”. The notary can then notarize your signature.

NCCPA - National Commission on Certification of Physician Assistants  www.nccpa.net;  (678) 417-8100

Licensure Applicants
licensure applicants must be currently certified by NCCPA. Applicant must request initial PANCE score report be sent directly to LSBME.
Temporary Licensure Applicants
to be issued a temporary license all requirements for licensure must be met except that the applicant has not yet taken or is awaiting the results of the examination. After examination the applicant must request a score report be sent directly from NCCPA to LSBME.

Verification of Other Licenses
Verification of all state licenses are required.  Contact the state board(s) directly to obtain verification of your license.  Please note, there may be a processing fee needed.​

Online Education Course and Quiz
Take and successfully complete the Online Education Course and Quiz. This course will review the Rules pertaining to the practice of physician assistants in the state of Louisiana. Instructions and enrollment key will be provided upon receipt of application.

Other Information

Verification of Application/Licensure Status
Visit our website at www.lsbme.la.gov and log on to your account to verify the progress/status of your application.

Communication with the Board
Mailing Address - LSBME, 630 Camp Street, New Orleans, LA 70130
Questions - Contact our licensing department at licensing@lsbme.la.gov. To find the analyst directly assigned to your application, click on Contact Us.