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Health Professional
Licensing/EMS Office

Department of Public Health & Social Services

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  • Home
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    • Emergency Medical Services
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Forms

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Emergency Medical Services

  • Ambulance Inspection Form PDF
  • Course Approval Request - FINAL
  • Emergency Medical Services for Children Health Fair Registration Form
  • EMS Certification Checklist
  • EMS-Certification Application
  • GUAM POLST Form
  • HPLO COMPLAINT form
  • Instructor Application - FINAL 2021
  • Consent for Release of Medical Record EMS_Fillable

Guam Board of Allied Health Examiners

  • Clinical Psychology Internship form
  • Collaborative Practice Agreement for Physician Assistant fillable
  • GBAHE Acupuncture Application Packet
  • GBAHE Audiology Application Packet
  • GBAHE Change of Contact Information
  • GBAHE Chiropractor Application Packet
  • GBAHE Clinical Psychology Application Packet
  • GBAHE Initial Application [R.07.2016]
  • GBAHE LPC, MFT, LMHC Application Packet
  • GBAHE Nursing Home Administrator Application Packet
  • GBAHE Nutritionist Clinical Dietitian Application Packet
  • GBAHE Occupational Therapy & OT Assistant
  • GBAHE Physical Therapy Assistant Application
  • GBAHE Physician Assistant Application Packet
  • GBAHE Renewal Application
  • GBAHE Request for Name Change
  • GBAHE RT & RT Assistant Application Packet
  • GBAHE Speech Language Pathology Application
  • GBAHE Veterinary Application Packet
  • HPLO COMPLAINT form
  • Record of Payment
  • Supervision Verification of CFY Candidate form

Guam Board of Barbering and Cosmetology

  • Apprentice Application
  • Establishment Application
  • GBBC Establishment Application
  • GBBC Record of Payment
  • HPLO COMPLAINT form
  • Initial Application for Examination
  • Reciprocity Application
  • Re-Exam Application - R.2017
  • RENEWAL Establishment Application
  • RENEWAL License Application
  • Special Japanese License

Guam Board of Examiners for Dentistry

  • GBED Ancillary Personnel App
  • GBED Ancillary Renewal App
  • GBED Dentist App
  • GBED Dentist Renewal App
  • GBED Record of Payment
  • GUAM BOARD OF EXAMINER FOR DENTISTRY (Complaint)
  • HPLO COMPLAINT form

Guam Board of Examiners for Optometry

  • GBEO_Application_for_Exam
  • GBEO Record of Payment
  • HPLO COMPLAINT form
  • RENEWAL APP - UPDATED

Guam Board of Examiners for Pharmacy

Pharmacist:

 
  • License by Examination
  • License by Endorsement
  • Certified Pharmacy Technician
  • Registered Pharmacy Technician
  • Pharmacy Intern
  • Local & Non-Resident Pharmacy, Facility, Wholesale
 


2021 New/Renewal Application


Application for Pharmacy/Facility


Other Documents


HPLO complaint form

Guam Board of Medical Examiners

Full License:


GBME – FULL LICENSE Application

 

Temporary License:


GBME – TEMP LICENSE Application

 

Limited License:


GBME- LIMITED LICENSE Application

 

Special License:


GBME- SPECIAL LICENSE Application

 

Reinstatement License:


GBME – Reinstatement License Application

 

2021 RENEWAL:


RENEWAL 2021 Application

 

Other Documents:

 
  • AMA_Position_Statement_on_Medical_Professionalism_2010
  • ABFM professionalism Guidelines
  • COMPLAINT FORM 2020
  • Full Medical License - CHECKLIST
  • HPLO COMPLAINT form
  • LIMITED application - Checklist
  • Record of Payment
  • Special License - Checklist
  • TEMPORARY License - Checklist

Guam Board of Nurse Examiners

  • 2021 APRN _ RN RENEWAL NOTICE
  • 2021 LPN RENEWAL NOTICE
  • 2021 RN RENEWAL NOTICE
  • CHANGE-UPDATE CONTACT INFORMATION-fillable
  • Continuing Education Report Form
  • Emergency Temporary Permit Application-Fillable
  • ESAR-VHP form
  • GBNE APPLICATION REQUIREMENT CHECKLIST
  • GBNE Exam_Endorsement_Reinstatement Application - Fillable 9-30-20
  • HPLO COMPLAINT form
  • NAME CHANGE REQUEST-fillable
  • Prescriptive Authority Application FILLABLE revised 9-30-20
  • Record of Payment - CASHIER'S COPY
  • Record of Payment
  • Renewal Application (fillable) Packet

Guam Board of Social Work

  • GBSW Interim Guidelines for Renewals_Approved 2021.05.06
  • GBSW-001 Exception Application 12.2020
  • GBSW-002 Verification of Clinical Supervision 2021.04
  • GBSW-004 Certificate of Exemption Application 12.2020
  • GBSW-006 Authorization for Release of Employment Records 12.2020
  • GBSW-007 Interim Application for Renewal of Exception Licenses 2021.04
  • HPLO COMPLAINT form

Guam Health Professional Licensing Office

194 Hernan Cortez Avenue, Terlaje Professional Building, Suite 213, Hagatna, Guam, 96910
 

> WEB ACCESSIBILITY STATEMENT

Information:


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Boards & Commission:


  • Emergency Medical Services
  • Guam Board of Allied Health Examiners
  • Guam Board of Barbering and Cosmetology
  • Guam Board of Examiners for Dentistry
  • Guam Board of Examiners for Optometry
  • Guam Board of Examiners for Pharmacy
  • Guam Board of Medical Examiners
  • Guam Board of Nurse Examiners
  • Guam Board of Social Work

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Search Providers

 

WORK IN PROGRESS


A new, modernized interactive online directory is in the works. It would be available soon. In the meantime, we are providing document (PDF directory) with the providers listing for each Board. 



 

Forms & Documents

 
View relevant forms and documents for each of the boards. We have made as many forms available online as possible. 

Government Holidays

 
2021
New Year’s Day January 1 (closed December 31st)
Martin Luther’s King’s Day January 18
Guam History & Chamorro Heritage Day March 1
Memorial Day May 31
Independence Day July 4(closed July 5th)
Liberation Day July 21
Labor Day September 6
All Soul's Day November 2
Veteran’s Day November 11
Thanksgiving Day November 25
Our Lady of Camarin December 8
Christmas Day December 25 (closed December 24th)

Staff & Management

 
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Contact

 
Content coming soon

Email

 
Content coming soon

Hours

 
8am – 4pm, Monday thru Friday
Closed on Government Holidays

Location

 
Mailing/Physical Address:
194 Hernan Cortez Avenue, Terlaje Professional Building, Suite 213, Hagatna, Guam, 96910

> Location Map

Guam Board of Allied Health Public Hearings on Proposed Legislation

 







 

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