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