Resources

An online library of the Board's various forms, publications, brochures, alerts, statistics, and medical resources.

Need Help?

Contact the Board's Consumer Information Unit for assistance.

Toll Free:
(800) 633-2322

Forms

Below are all forms used by the Medical Board of California. If you need assistance filling them out, contact our Consumer Information Unit at (916) 263-2382.

Applicants

In an effort to move to a paperless application process, the Board removed Application for a Postgraduate Training License (Forms PTL1-PTL4) and Application to Transition from a Postgraduate Training License to a Physician's and Surgeon's License (Form TF1-TF3).

Effective February 1, 2023, the Board will no longer accept, and process, the following paper applications, as they must be submitted online through BreEZe Online Services:

• Application for a Postgraduate Training License (Forms PTL1-PTL4)
• Application to Transition from a Postgraduate Training License to a Physician's and Surgeon's License (Form TF1-TF3)

Physicians and Surgeons

Postgraduate Training License (PTL) Application Forms

• Application for a Postgraduate Training License Information & Checklist
• Request for Live Scan Service Form for Electronic Fingerprints
• Explanation for Application Question (Form EXP)
• Timeline of Activities (Form TOA)
• Certificate of Medical Education (Form MED)
• Certificate of Completion of ACGME/RCPSC/CFPC Postgraduate Training (Form PTA-PTB)
• Research During Training Questionnaire (Form RES1-RES2)
• Postgraduate Training License Enrollment Form (Form EF)

Physician's and Surgeon's License Application Forms

• Application for a Physician's and Surgeon's License Information & Checklist
• Request for Live Scan Service Form for Electronic Fingerprints
• Explanation for Application Question (Form EXP)
• Timeline of Activities (Form TOA)
• Certificate of Medical Education (Form MED)
• Certificate of Completion of ACGME/RCPSC/CFPC Postgraduate Training (Form PTA-PTB)
• Certificate of Completion of CODA Postgraduate Training (Form CODA1-CODA2)
• Current Postgraduate Training Verification (Form CTV)
• Limited Practice License (Form LPL), if applying for Limited Practice status

Transition from a Postgraduate Training License (PTL) to a Physician's and Surgeon's License Application Forms (PTL Holders Only)

• Application to Transition from a Postgraduate Training License to a Physician's and Surgeon's License Information & Checklist
• Explanation for Application Question (Form EXP)
• Certificate of Medical Education (Form MED)
• Certificate of Completion of ACGME/RCPSC/CFPC Postgraduate Training (Form PTA-PTB)
• Current Postgraduate Training Verification (Form CTV)
• Limited Practice License (Form LPL), if applying for Limited Practice status

Other Forms and Information

• Program Status Update/Change (Form PSU1-PSU2)
• Translation of International Academic Credentials
• Notification of Name Change
• Applicant Address Change Request
• Fictitious Name Permit Application and Checklist
• Direct Online Certification Submission (DOCS) Flyer and Form, for use by medical school or program officials only

Physician's and Surgeon's Initial License Renewal Forms

• Initial License Renewal Verification of ACGME/RCPSC/CFPC Postgraduate Training (Form ILR)
• Certificate of Completion of CODA Postgraduate Training (Form CODA1-CODA2)
• Research During Training Questionnaire (Form RES1-RES2)

Midwives

• Application for Midwifery License
• Live Scan Service Form for Electronic Fingerprints (Midwives) , for Midwives applicants only

Polysomnography

• Application for Polysomnography Registration
• Live Scan Service Form for Electronic Fingerprints (polysomnography) , for Polysomnography applicants only

Research / Student Research Psychoanalysts

• Application for Research/Student Research Psychoanalyst
• Live Scan Service Form for Electronic Fingerprints (RP) , for Research/Student Research Psychoanalysts applicants only