Forms
Publications
Brochures
Brochures List
A Patient's Guide to Blood Transfusion
Be an informed Patient Check up on Your Doctor's License
Breast Cancer Treatment
A Consumer's Guide to the Complaint Process
Expert Reviewer Program
Don't Wait, File a Complaint!
Gynecologic Cancers...What Women Need to Know
Questions and Answers About Investigations
Most Asked Questions about Medical Consultants
Prostate Cancer Patient Guide
Silicone Implants
Medical Resources
Statistics
License Verification System (LVS)
BreEZe Resources Center
Need Help?
Contact the Board's Consumer Information Unit for assistance.
1 (800) 633-2322
Send a MessageForms
Below are all forms used by the Medical Board of California. If you need assistance filling them out, contact our Consumer Information Unit at (916) 263-2382.
Tips for Viewing and Using Fillable PDFs
Licensees
- Notice of Change of Address/Email
- Notification of Name Change
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Physicians and Surgeons
- Application for Cancellation of a Fictitious Name Permit
- Application for Waiver of Continuing Medical Education During Renewal Cycle
- Application for Duplicate Certificate
- Application for Duplicate Fictitious Name Permit
- Application for Inactive License
- Application for Voluntary Surrender of License
- Application to Restore License to Full, Active Status from Inactive, Disabled or Fee Exempt Status or from Disabled Status to Active Status with Limitations on Practice
- Armed Forces Personnel Application for Exemption from Payment of Renewal Fee
- Disabled Physician Application for Exemption from Payment of Renewal Fee
- Fictitious Name Permit Application
- Fictitious Name Permit Change of Address Form
- Fictitious Name Permit Notification of Partnership Change
- Fictitious Name Permit Notification of Shareholder Change
- Fictitious Name Permit Notification of Renewal/Hold Release
- Petition for Penalty Relief
- Physician Orders for Life Sustaining Treatment (POLST) form
- Retired Physician Application for Exemption from Payment of Renewal Fee - No Practice Allowed
- Voluntary Service Physician Application for Waiver from Payment of Initial License or Renewal Fee
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Midwives
- Licensed Midwife Disclosure Form
- Midwife Application for Inactive License
- Midwife Application to Restore License to Full, Active Status from Inactive or Retired Status
- Retired Midwife Application for Exemption from Payment of Renewal Fee - No Practice Allowed
- Transfer of Planned Out-of-Hospital Delivery to Hospital Reporting Form