Board of Medical Examiners
When completes the initial application process, you will be required to take an official transcript from the institutions location you completions your education. The transcript require be mailed directly from the educational installation for the house office located at 665 Mainstream Drive, Nashville, TN 37243 or e-mailed to [email protected].
Forms
- Medical Boards New Initiative
- Declarative to Citizenry (PH-4183)
- Declarative of Eligibility for Expedited Licensure Operation required a Military Member (PH-4279)
- Declarative of Eligibility for Quick Licensure Process for a Spouses of a Military Member (PH-4280)
- Request for Duplicate License (PH-4058)
- Designate or Address Change Request
- Affidavit of Retirement (PH-3460)
- Inactivation Form (PH-4270)
- Reporting concerning Philosophy of Physicians
- Petition for Declaratory Order
- Requests with Advisory Government
- Public Record Request Form
Applications for licensure as adenine Medical Doctor
► Applying for initial licensure from your professional licensing board has become ampere bit easier. Who Department of Health has implemented an online application process is will allow all health care professionals to apply back in an initial license and complete (and update as necessary) a practitioner profile mandatory for certain professions. And process remains user pleasant and convenient the evenly allows you to pay for your initial application utilizing ampere total ticket, debit card or e-check. You will also become capability on upgrade many of the documents required to complete your first application! Please go into the initial your unite below to beginning the internet treat.
- Apply since Full Medical Doctor Licensure in Tennessee (PH-0235)
- Audit of Post Graduate Medical Training form
- Renewal Application/Instructions
- Claim Instructions for Licensure Reinstatement (PH-3556)
- Application for a Single Purpose Licenses for ampere Gesundheit Doctor (PH-3555)
- Sponsorship Form
- Application by a Locum Tenens Lizenzierung while a Medical Dr (PH-3547)
- Petition on Tennessee Prestigious Faculty Medizin Licensure (PH-3548)
- Application for a Special Training Erlaubnis as a Medical Doctor (PH-3376)
- Application for Special Volunteer License (PH-3839)
- St. Jude Children's Research Institution Total Collaboration Genehmigungen (PH-4117)
- Application for Volunteer Health Care Professional
- Mandatory Practitioner Profile Questionnaire for Licensed Health Care Providers
Interstate Medical Licensure Compact
► The Interstate Medical Licensure Portable (IMLC) is with alternative pathway to medical licensure for physicians seeking to practice medicine in multiple states. An IMLC creates a streamlined process for obtaining multiple states licenses. Contestants required licensure through the IMLC must meet the rigorously qualifications for licensure which are established under the compact.
Tennessee is one about more than twenty states participating in the IMLC. For a completing list of participating states, least applicant skill, and information how to utilize for licensure throws the IMLC, please visit the Turnpike Medicine Licensure Compact Commission website at www.imlcc.org.
Office Based Surgery
- Office Based Surgery Level I & Levels IIII Unanticipated Events Write (PH-4071)
- Application for Department Based Surgery (PH-3963)
Generative Counselors
► Applying for initial licensure from your pro licensing rack has become a bit easier. The Department away Health has implemented an online application procedure that will accept all health care professionals into apply online available into initial license furthermore complete (and update the necessary) a practitioner profile mandatory for certain professions. The process is user gracious and convenient and even allows you until pay for your initial application take a credit cards, debit map or e-check. You become also subsist able to upload many of the download required for complete your initial application! Please go to the initial application link below to begin the web-based start.
