1. Completed, signed and notarized application. Enclose the following items:
   
   
   1. 8 1/2" x 11" copy of your PA school diploma or certificate and an 8 1/2" x 11" notarized copy of your National Certifying Certificate.
   2. Check or money order made payable to the "State of Delaware" for the non-refundable processing fee.

2. Verification of Physician's Assistant education
   
   In addition to sending a notarized copy of your PA school diploma or certificate, the Delaware Board of Medical Practice requires verification of your education. Use the Verification of Physician Assistant Education form. If more than one school was attended, provide a copy of the form to each PA school that was attended. This report must be sent from the school directly to the Delaware Board of Medical Practice office.

3. Verification of National Certifying Certificate
   
   The National Commission on Certification of Physician Assistants is responsible for the administration of the Physician Assistant National Certifying Exam (PANCE). Request that PANCE scores be released to the Delaware Board of Medical Practice by sending a signed request with your name and Social Security Number to:
   
   NCCPA
   12000 Findley Road
   Suite 200
   Duluth, GA 30097
   
   This report must be sent directly to the Delaware Board of Medical Practice office. For more information, see http://www.nccpa.net/.

4. Verification of licensure in good standing
   
   The Delaware Board of Medical Practice requires primary verification from the State Licensing Board of all medical licenses that you now hold, or have ever held. Use the Verification of Physician Assistant License form. This includes any medical training license. Check with the individual states to determine if a fee is required. These reports must be sent from the State's Licensing Boards directly to the Delaware Board of Medical Practice office. (Internet verifications or FAX verifications will not be accepted.) The Delaware Board of Medical Practice requires verification with the State Board seal.

5. Self query from the National Practitioner Data Bank (NPDB) and Healthcare Integrity and Protection Data Bank (HIPDB)
   
   The Delaware Board requires a self-query from the NPDB and HIPDB. A self-query is a practitioner's request for information in the NPDB and HIPDB about himself or herself. All self-query requests are automatically submitted to both the NPDB and the HIPDB. You may self-query by completing and returning a signed and notarized Practitioner Response to Information Disclosure (Self-Query) form or by calling the NPDB Help Line at (800) 767-6732.
   
   The response to a practitioner's self-query application is mailed to the applicant's address on the application. If the mailing address is not identified, the response is sent to the practitioner's home address. When you receive the self-query from the NPDB and HIPDB, review the information to ensure it is accurate. If the report is correct, please submit the original report to the Delaware Board of Medical Practice office.

6. Criminal Background Checks (Effective July 1, 2007)
   
   Complete the Criminal History Record Check Authorization Form and take it to the Delaware State Bureau of Identification (SBI) or to your local SBI or equivalent agency in your state (e.g., State Police headquarters) to obtain the following:
   
   
   • Report of your entire criminal history from the SBI or the equivalent agency in your state or a statement from the agency that the state central repository contains no criminal history relating to you
   • Report of your entire federal criminal history pursuant to the Federal Bureau of Investigation appropriation of Title II of Public Law 92-544 (28 U.S.C. § 534).

   You must request these reports at your own expense. For more information about requesting criminal history records, contact the Delaware SBI at (302) 739-2528 or your local SBI.

   You may not be licensed to practice as a physician assistant until your criminal history reports have been received. If your record shows a prior criminal conviction, you may not be lcensed to practice unless the Board grants a waiver.

A checklist of required licensure documentation can be found by clicking here.

Physician's Assistant Prescriptive Authority

A licensed Physician Assistant may apply for controlled or non-controlled prescriptive authority by submitting a completed Physician Assistant Application for Prescriptive Authority to the Board office. This licensure will allow the Physician's Assistant to prescribe medication under the supervision of a licensed physician in the State of Delaware.