Board of Medical Practice - Licensing and Fees
We are pleased to announce our online licensing system!
Using this Web based system, providers can apply, renew, and update their personal information online, as well as pay any licensure fees via credit card. Members of the public can look up health care professionals licenced by the Board. Click the icon to get started:
Applications
Please note: Applications will not be complete without the submission of additional forms that must be downloaded from this site.
All forms must be mailed to:
Vermont Board of Medical Practice
108 Cherry Street
PO Box 70
Burlington, VT 05401
For questions related to licensing, please contact our office:
Tracy Hayes
802-657-4223
Main Line: 802-657-4220
Fax: 802-657-4227
Fees
Physicians, the initial and reinstatement application fee is $625.
The renewal application fee is $500.
Podiatrists, the initial and reinstatement application fee $625.
The renewal application fee is $500.
Limited temporary licensure, the intial and renewal fee is $70.
Physician Assistants the intial and renewal fee is $170.
Anesthesiologist Assistants the initial and renewal fee is $115.
Radiologist Assistants the initial and renewal fee is $115
Verification of licenses and certifications the fee for each verification is $50.
Reprints of licenses, the fee for each reprint is $20.
Physician
You MUST submit these forms in addition to completing the online application.
- Physician Initial Application Forms
- Limited Temporary Physician License Forms
- Physician Reinstatement Application Forms
- Malpractice Reporting Forms (Form A)
Podiatrist
You MUST submit these forms in addition to completing the online application.
Physician Assistant
You MUST submit these forms in addition to completing the online application.
- Physician Assistant Initial Application Forms
- Additional Site Documents for Physician Assistants
- Notification to the Board of Termination of Employment Contract
Important: New Procedures for Physician Assistants
The Board of Medical Practice is working on new procedures relaed to recent statuatory changes. For physician assistants, one of the most significant is the transition to statewide licensure. That means the process for a PA who wants to establish an additional practice site will be easier and faster.
Until further notice, the process for establishing a new practice site will be to simply send a letter to the Board, Attn: Tracy Hayes, stating:
- Your name
- The numbers of any still-current Vermont certifications
- Your primary practice site
- A delegation agreement and physician forms for the primary and, if any, secondary supervising physicians for the additional practice site
- Acknowledgement that you are aware of the new section on physician assistant supervision, which may be found online by following this link: 26 V.S.A. § 1735a, or searching the Vermont General Assembly website at http://leg.state.vt.us
The letter and supporting documentation must be filed prior to beginning at the additional practice site.
For more information please contact the board at 802-657-4223
Anesthesiologist Assistant
You MUST submit these forms in addition to completing the on-line application process.
Radiologist Assistant
You MUST submit these forms in addition to completing the on-line application process.