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Physician Forms

New Licensure Applications:

Full Licensure for both family and specialties
Must apply at Once application is received an application package will be sent to obtain the additional documents that are required to complete registration and licensing.

Post Graduate
Post Grad Application and Checklist
Prescription Privilege Undertaking Form

Medical Student
Medical Student Application

International Medical Graduate
Yukon is not currently accepting applications from IMGs. You must meet the requirements for full licensure.

Medical Professional Corporation
Prof Corp Application

Yukon Hospital Privileges
Application Process for Residents, Medical Students and Observers to Obtain Yukon Hospital Privileges


Licensure Renewal:

Full Licensure –Due March 1st
Med Professional Renewal Form

Medical Professional Corporation – Due December 1st
Prof Corp Renewal Form


Other Forms:

Fee Schedule

Marijuana for Medical Purposes - Patient Medical Document

Methadone Authorization Request Form

Physician Triplicate Prescription Program Application

Request for Certificate of Standing (or Certificate of Professional Conduct) Form

Supervised Practice Assessment Form - Limited Family Practice Licensed Physicians



Yukon Medical Council -