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Surgical Assistant

If you have questions pertaining to information on this page, contact Dawn Beahl (502) 429-7938 or by email dawn.beahl@ky.gov.

Application For Certification

To apply for Surgical Assistant Certification, review all of the following items prior to clicking on the Application link below.

To determine eligibility for Surgical Assistant Certification review these requirements:

  1. Once you click on the application link, you will be required to create a login profile by choosing "Don't have a login, click here." on the top of page.
  2. After you have created a login profile, you have initialized your application process which consists of demographic information only.
  3. Upon completion of the login profile, you will be prompted to "Click Here To Apply For License."
  4. After completing the online application, you will be prompted for a $50.00 non-refundable application fee. Payment may be made by credit card or ACH debit.
  5. Once the payment is complete, you will be directed to a link for application addendums. These addendums are required for your application to be considered complete.
  6. *Click Here to Begin Application Process

*The above link is for new applicants only. If you have an inactive certificate, contact the Board at the number above.  Please do not create a new account and pay the application fee. This fee is non-refundable.

Surgical Assistant Committee Members

  • Roy Tyler, KCSA, Bowling Green, Chairman
  • Jeri Anna Fritz, RN, Louisville
  • Salem M. George, Jr., M.D., Louisville
  • Beckie Miller, RN, KCSA, Owensboro
  • Eva M. Owen, KCSA, Louisville

Statutes and Regulations

Kentucky Revised Statutes - Chapter 311

Kentucky Administrative Regulations - KAR's

Meeting and Deadline Dates

Fee Schedule

Duplicate Forms

If at any time you need additional and/or duplicate application forms, you will need to log into your profile and access the instructions/forms​. This is the only way to obtain these forms.​