Section, sign, date and return the form directly to the
Online Form 1 - Application for Licensure All applicants for licensure must initially submit Form 1 along with the $115 licensure and first registration fee.
Note: For fillable PDF forms, Internet Explorer is the recommended browser. To renew your registration online, visit If your registration has lapsed for longer than 4 months, submit a Delayed Registration Application. To practice in New York State, your professional license must be registered. A New York State professional license is valid for life unless it is revoked, annulled, or suspended by the Board of Regents. License Application Forms Physician Assistant Important Notice: DO NOT use Form 1 if you are already licensed in this profession in New York State.