This form is for use by RCLs ONLY!
Please fill out all of the fields. If you're unsure of a specific item, please type TBA, and you can either re-submit the form or email the GAPA Office with the update once you have it. Thank you for your time!
Georgia Association of Physician Assistants 1905 Woodstock Road Suite 2150 Roswell, GA 30075 Voice: 770-640-1920 Toll Free: 1-888-811-GAPA Fax: 770-640-1095 info@gapa.net