Hawaii Medical Board Application Forms

Requirements and License Application Form
Do not proceed with this application if you have been subject to disciplinary action by a medical licensing authority, do not hold a permanent license in another jurisdiction, or do not have 2 years of active clinical practice in the preceding 5 years from the submission of your application.

• Requirements and License Application Form
• Federation Discipline Report Form
• Hospital Form

• Requirements and License Application Form
  Temporary license to practice for the duration of the active-duty military member’s service in Hawaii.

Apply for a Osteopathic Physician & Surgeon Medical License through the IMLCC

• As of January 1, 2025, full and restricted licenses by compact are available by applying through the Interstate Medical Licensure Compact Commission (IMLCC).  Please review the compact eligibility requirements on the IMLCC website at https://imlcc.com/information-for-physicians/

What is the Interstate Medical Licensure Compact (IMLC)?

• The Interstate Medical Licensure Compact is an agreement among participating U.S. states and territories to work together to significantly streamline the licensing process for osteopathic physicians who want to practice in multiple states.  It offers a voluntary, expedited pathway to licensure for physicians who qualify.

How do I apply for a compact medical license?

• Initiate applications directly through the IMLC Commission’s website at: https://imlcc.com/.

Disclaimer: Hawaii is not yet a State of Primary License (SPL).  Interested applicants for initial compact licensure will need to establish another state as their SPL.
For all compact related questions, please contact the IMLCC directly at inquiry@imlcc.net or (303) 997-9842.

• Requirements and License Application Form
  Do not proceed with this application if you have been subject to disciplinary action by a medical licensing authority, do not hold a permanent license in another jurisdiction, or do not have 2 years of active clinical practice in the preceding 5 years from the submission of your application.

• Requirements and License Application Form
• Certificate of Competency Form

• Requirements and License Application Form
  Temporary license to practice for the duration of the active-duty military member’s service in Hawaii.

• License Application and Renewal Form – MDR/DOSR
• Program Director/Hospital Representative Attestation Form – MDR/DOSR

• Requirements and License Application Form

• Requirements and License Application Form
• Federation Discipline Report Form – (Physician)
• Hospital Form
• Sponsor/Alternate Sponsor Statement

• Requirements and License Application Form
• Subchapter 6 (Certifying Physician Assistants)
• Verification – Supervising Physician Form
• Federation Discipline Report Form – (Physician Assistant)
• Inactivate/Reactivate License Form (Physician Assistant)

Inactivate License During Renewal Or Reactivate Your Physician Assistant License

INACTIVATE LICENSE DURING RENEWAL PERIOD (Physician Assistant Only)

If you need to renew your license and want to place your license on an inactive status:

Hardcopy renewal form may be requested by contacting:  The Professional and Vocational Licensing Branch at (808) 586-3000 OR

Pick up at office location:
King Kalakaua Building 335 Merchant Street, Rm. 301 Honolulu, Hawaii 96813

Hours of Operation:

The DCCA will be open 7:45 AM – 4:30 PM (Hawaii Standard Time), Monday to Friday, except state holidays.

Please be advised that a licensee on inactive status shall be considered as unlicensed and shall not engage in the practice of the licensed profession or vocation.

Any person who violates this prohibition shall be subject to discipline under this chapter and the laws and rules of the licensing authority for that license.

It shall be the responsibility of each licensee on inactive status to maintain knowledge of current licensing and renewal requirements

REACTIVATE LICENSE (Physician Assistant Only)

• File: Reactivation Application Form
• Submit Form, Required Documentation and Applicable Fees

• Requirements and License Application Form
  Temporary license to practice for the duration of the active-duty military member’s service in Hawaii.

• Requirements and License Application Form
  Temporary license to practice for the duration of the active-duty military member’s service in Hawaii.

• Requirements and License Application Form
• Temporary Certificate Application Form
• Verification of License/Certificate Form
• Verification of National Registry Certificate Form