It is the responsibility of the A.A. to submit an application in a timely manner to ensure it is received and reviewed by the Board within the intended month. Click here to access the Board’s agenda deadline schedule.
Before you begin, you should thoroughly read Board Rules, Chapter 540-X-7, Assistants to Physicians. Click here to read the rules.
Both a state license and a registration agreement to a supervising physician are required to practice as an anesthesiologist assistant in Alabama.
Presently, an initial license and registration agreement may be obtained at the same time. Although licensing is a one-time process, a registration agreement is required for each new professional relationship.
Before you begin this application, review the list below and ensure you have each of the required documents and available funds. Once you begin the application process, you will not have the opportunity to save and complete the application at a later time. Please ensure you have what is required before you begin.
The following items are required to complete the online application:
1) Diploma reflecting graduation from an approved A. A. training program
(Transcripts are not acceptable)
2) NCCAA certificate/certification of successful completion of the examination
3) Funds of $265.00 for the payment of the license fee and the criminal history background
4) Supporting documentation for Declaration of Citizenship; click here to view a list of valid
5) Color photograph taken within sixty days prior to the date of this application
Fingerprint Card Request
You must request fingerprint cards for your criminal background check. Send an email to the Director of Assistants to Physicians Kimie Buley. Please be sure to include your mailing address in your email request. You must also submit the Application To Review Alabama Criminal History Record Information to conduct your criminal background check. This form should be mailed to the Board along with your two completed fingerprint cards. Click here to obtain the required form.
Waiting to receive information from another entity can cause delays in a licensure application being placed on the Board's agenda (i.e., license verification from other states, copy of a diploma, and criminal background results).
Are you currently* engaged in the excessive use of alcohol, controlled substances, or the use of illegal drugs, or received any therapy or treatment for alcohol or drug use, sexual boundary issues or mental health issues? (If you are an anonymous participant in the Alabama Professionals Health Program and are in compliance with your contract, you may answer "No" to this question, such answer for this purpose will not be deemed upon certification as providing false information to the Alabama Board of Medical Examiners)
*The term “currently” does not mean on the day of, or even in the weeks or months preceding the completion of this application. Rather, it means recently enough so that the condition referred to may have an ongoing impact on one’s functioning as an assistant to an anesthesiologist within the past two years.
Applicant’s Education (since graduating from high school)
Applicant’s Activities since graduating from high school (cover all time periods)
Certification of Licensure
Select all states where you have been certified/registered/licensed as an Anesthesiologist Assistant, if applicable. Primary source verification is required from any state that does not report anesthesiologist assistant data to the Federation of State Medical Boards.
Click Here to print a license verification form
Citizenship-U.S. Citizenship or National Status
I declare under penalty of perjury under the laws of the State of Alabama that the answers and evidence I provided are true and correct to the best of my knowledge.
Certification and Release
Review Page – If everything is correct, press “Next”
Affirm And Submit
Board of Medical Examiners charge will appear on your statement with a description including IGOVSOL*
When entering dates attended in the education sections if you do not know the exact date use the first date of the month. (Example: you attended from August 1990 – July 1994, enter 08/01/1990 – 07/01/1994)
P.O. Box 946 / Montgomery, AL 36101-0946 / (334) 242-4116