Forms & Information Required for Licensure and Certification in Vermont
All applicants MUST complete BOTH the online application and the forms below. Applications will not be complete without the submission of the forms that must be downloaded from this site.
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For resources and information about the Vermont Prescription Monitoring System (VPMS) click here.
| Licensing | Type | Fees |
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Verifications: Our website is considered a Primary Source verification; however, some states may require direct verification. If you would like to have your verification expedited, you are required to provide a prepaid FedEx or USPS envelope. We no longer use UPS for expedited mailings and will not send UPS packages or envelopes. We do not have prepaid envelopes. If you want an expedited mailing, you must include the envelope and a prepaid label with your request. |
All Licenses and Certifications | $50 per verification |
| Reprints | All Licenses and Certifications | $20 per reprint |
| Submit your request for a verification or reprint in writing. Note where to send the documents and include the payment of cash, check, or money order payable to the Vermont Department of Health. Mail to the Vermont Board of Medical Practice, 108 Cherry Street, Burlington, VT 05401. |
| Applications | Type | Fees |
| Physician & Podiatrist | Initial Application | $650 |
| Reinstatement Application | $650 | |
| Renewal Application | $525 | |
| Limited Training License | Initial and Renewal Application | $75 |
| Physician Assistant | Initial Application | $225 |
| Renewal Application | $215 | |
| Anesthesiologist Assistant | Initial and Renewal Application | $120 |
| Secondary Site Additional Application | $55 | |
| Secondary Site Renewal Application | $55 | |
| Radiologist Assistant | Initial and Renewal Application | $120 |
| Secondary Site Additional Application | $55 | |
| Secondary Site Renewal Application | $55 |
You MUST submit these forms in addition to completing the online application. If you are using the FCVS, you do not neet to print out the Medical School Verification Form (UA #2) or the Post-Graduate Training Verification Form (UA #3). That information will be verified and included in the FCVS packet.
You MUST submit these forms in addition to completing the online application. If you are using the FCVS, you do not neet to print out the Medical School Verification Form (UA #2) or the Post-Graduate Training Verification Form (UA #3). That information will be verified and included in the FCVS packet.
- PA Initial Application Forms
- PA CME Board Rule Requirements
- PA Notification of Termination with Participating Physician Form
- Malpractice Reporting Form (Form A)
- Excerpt of Proposed Rules for Physician Assistants (October 27, 2021)
Act 123 of 2020 Updates Laws Regarding Physician Assistant Practice Agreements: Pending issuance of rules, the new law makes significant changes to the requirements for physician assistant supervision and the documentation that must be filed with the Board.
You MUST submit these forms in addition to completing the online application.
You MUST submit these forms in addition to completing the online application.
You MUST submit these forms in addition to completing the online application.
Licensees are required to promptly reports all forms of adverse information such as: discipline by a hospital or other state licensing body, malpractice cases or arrest. If you have been the subject of such action, and you have not yet reported it to the Board, you must do so now.
How must it be reported?
- Use the Malpractice Reporting Form (Form A)
- Use the required online application to list the information by date in response to question 112 or 113, as appropriate, and
- Submit documentation including the complaint and settlement, release, or other final disposition of the matter
What must be reported?
- Pending malpractice actions in which you are a named defendant
- Settlements paid on your behalf
- Arbitration awards paid on your behalf
- Judgements entered against you
- Changes to a matter prevously reported (eg: a matter previously reported as a pending malpractice case has resulted in a judgement, or has been resolved in your favor)
What does NOT need to be reported?
- Matters that have previously been reported. You need only review the information in your history to verify that it is complete
- Closed cases for which there was no settlement, arbitration award or judgement. You are not asked to list cases that were dismissed or withdrawn with no findings against you and no payments to the complaining party.
- Cases that resolved in your favor
- Cases in which you prevailed or the matter was withdrawn without payment
Please Note: If you previously reported a case when it was pending, you may report it if it was resolved in your favor, but you are not required to do so.
If you have any questions, contact the Board: 802-657-4223.
Renewals require a completed online application and all required documentation plus payment.
Expiration Dates
| Profession | Date |
| Physicians | November 30 of Even Years |
| Podiatrists | June 30 of Odd Years |
| Training Licenses | June 30 of Every Year |
| Physician Assistants | January 31 of Even Years |
| Anesthesiologist Assistants | January 31 of Even Years |
| Radiologist Assistants | January 31 of Even Years |
Log Into Your Account to Renew Your License or Certification
IMPORTANT: If you currently hold a license or certification in Vermont, you already have an account and do not need to register. If you need your username and password, use the Recover User ID/Password feature. If this does not work email [email protected].
Step 1: Log into your account.
Step 2: From the ONLINE SERVICES menu in the upper right corner of the screen, choose "CREATE/CONTINUE RENEWAL" to start the application.
- If you do not see your information pre-populated in the application, you have chosen the incorrect application.
- Please make sure you have chosen the renewal application.
If you have questions, call 802-657-4223 or email [email protected]
To check the status of your application, log into your account and follow these steps:
1) Choose "APPLICATION STATUS" from the online services menu in the upper right corner of the screen, and
- This will tell you which items are required to complete your application.
- Your application will not be processed until ALL information is received by the Board.
- If the status page is blank, please go back to ONLINE SERVICES and follow Step 2 below.
2) Choose "LOOK UP A LICENSE" from the ONLINE SERVICES menu, enter only your LAST NAME and choose SEARCH.
- If your credential status says "ACTIVE" then your license should arrive in the mail shortly.
- If you are in a renewal period and your status says "ACTIVE IN RENEWAL" go to Step 3 below.
3) If you look up your license and it still says "ACTIVE IN RENEWAL" and you have already checked your status
- From the ONLINE SERVICES menu, choose "CREATE/CONTINUE RENEWAL."
- Verify your renewal is complete and has been submitted.
If you need your username and password, use the Recover User ID/Password feature. If this does not work, please email [email protected].