The fee to renew your license is $150.00 by March 31, 2017. Late renewal can be made by paying $200.00 between April 1, 2017 and April 30, 2017. After May 1, 2017, your license will be placed inactive for non-payment of your renewal.
- If you have not previously submitted a course completion certificate to the Board for Pediatric Abusive Head Trauma, you must do so in order to renew your license. Pursuant to KRS 311.844 section (3)(d), the Board shall ensure that physician’s assistant shall demonstrate completion of a one-time training course of one and one-half (1.5) hours of training covering the prevention and recognition of pediatric abusive head trauma, as defined in KRS 620.020. The completion certificate may be faxed to Teresa Kleinhenz at (502) 429-7158 or emailed to email@example.com .
Instructions for Renewal
To begin your renewal, please read the instructions below and then click on the 2017 Application Renewal link. All parts of your renewal may be completed online with the exception of the Physician Assistant Evaluation Survey. Please be advised that your application will not be considered complete until your Primary supervising physician(s) complete the Physician Assistant Evaluation Survey and submit this survey to the KBML. You may print this survey in step 8 below.
If you would like to check the Board’s records and verify the Primary supervising physician(s) listed for you, click here and enter your Kentucky license number (must include PA letters before the number). Your profile information will display all Primary supervising physician(s). If you need to remove any supervising physician(s), please email Teresa Kleinhenz at firstname.lastname@example.org .
This application works best with Internet Explorer and the Firefox browser. There are some compatibility issues with Apple and the Safari browser. Google Chrome requires the user to scroll up/down and right/left to see the entire renewal screen. If you log on and see a blank screen, please use a different browser.
- You will be prompted to enter a username and password once you click on the link below.
- Username is your KY license number (including the PA letters before the number) and password is the last 4 digits of your Social Security Number. Do not create a new profile at the login screen.
- You will see a welcome screen. Click on Click Here to Renew Your License next to the License Renewal Information section.
- To begin processing your information, click on Click Here to Renew.
- The application will require you to enter a mailing and practice address. If you do not have a practice address, please enter “No street available” on the street line; “No city available” on the city line; enter “Kentucky” for the state and enter a Kentucky zip code. THESE FIELDS ARE MANDATORY AND MAY NOT BE LEFT BLANK.
- Once your information has been completed, you will be prompted to pay using a credit card or ACH debit. The payment screen is a pop-up window – Please make certain your browser allows pop-up windows.
- You will have the opportunity to print a receipt upon completion of payment. A receipt will also be emailed to the email address you list on the payment screen.
- Please make certain you print the PA Evaluation Survey and complete for all primary supervising physicians on record for your license.
- Click here to begin your online application.
IMPORTANT: Please make certain you have read the instructions above before proceeding with your renewal. Log in using your Kentucky license number (including the PA letters before the number) as your username and the last four digits of your social security number as your password.
2017 Paper Application
The paper application should only be completed if you are required to answer “yes” to a qualifying question. If answering “yes,” you will not be permitted to continue online. The online renewal system will prompt you to print a paper application. Upon completion of the paper application, please mail to the Board with the required renewal fee.
Important Information For Paper Applications
It is imperative that you provide ample time for the Board to review an application that requires an affirmative answer. Please do not wait until the license deadline to submit your application as it can delay the renewal of your medical license.
- If you are being treated by a physician for a mental or physical condition, your treating physician must provide a letter attesting to your ability to practice medicine.
- Malpractice disclosure must be accompanied by legal documentation, example: Settlement Agreement, Jury Trial information, etc.
- Driving Under The Influence disclosure must be presented with all legal documentation.
- If a licensing Board has taken action against your medical license, you must attach the Board Order to your license application.
2017 Physician Assistant Renewal Paper Application
Physician Assistant Evaluation Survey