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How to use or fill out California Medical Board Form L5 2012
- Click ‘Get Form’ to open it in the editor.
- Begin by entering your personal information in the 'Applicant Information' section. Fill in your last name, first name, middle name, date of birth, and U.S. Social Security Number clearly.
- In the 'Medical School of Graduation' section, ensure you provide the name of your medical school and complete the form in English as required.
- Document your clinical clerkships under 'Clinical Subject.' List one subject per line along with the facility name, city/state/province/country, and dates of attendance in chronological order.
- For each clinical experience, indicate the weeks or weekly clinical hours spent at each facility. Ensure all entries are accurate and complete.
- The 'Medical School Official Certification' must be completed by an authorized official from your medical school. They should print their name, title, sign, and date the form.
- Finally, remember that this form must be mailed directly from your medical school to the Board for it to be accepted.
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How much is the medical board license fee in California?
Licensing Changes NamePrior Fee AmountNew Fee Amount Effective 1/1/2024 Initial License Fee - Physicians Surgeons $ 863.00 $ 1,151.00 Initial License Fee - Special Faculty Permit $ 863.00 $ 1,151.00 1/2 Initial License Fee - Physicians Surgeons $ 431.50 $ 575.50 Biennial Renewal - Physicians Surgeons $ 863.00 $ 1,151.005 more rows
How to find out if a doctor is board certified in California?
To determine a doctors status, go to the Medical Boards website or call (800) 633-2322 and someone at the Medical Board will look up the doctor for you.
What is reportable to the California Medical Board?
The types of complaints the Board handles include: Substandard care (misdiagnosis, negligent treatment, delay in treatment, etc.) Prescribing issues (violation of drug laws, excessive/under prescribing) Sexual misconduct, impairment (drug, alcohol, mental, physical)
Where do I mail my osteopathic Medical Board of California?
The material shall be mailed to the Boards Enforcement Unit at 1300 National Drive Suite 150, Sacramento, CA 95834.
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