Document Submission Cover Sheet - Georgia Secretary Of State

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SECRETARY OF STATE
PROFESSIONAL LICENSING BOARDS DIVISION
237 Coliseum Drive
Macon, Georgia 31217
Phone (478) 207-2440
DOCUMENT SUBMISSION COVER SHEET
Please use this form as a cover sheet for submitting your document(s) for initial application or for renewal of your
professional license. You may fax your document(s) along with this cover sheet directly to the Board office using the fax
number below which corresponds to your profession, or you may mail your document(s) along with this cover sheet to the
svd@sos.ga.gov
Board office at the address listed above, or you may email them to
. Be sure the document(s) you are
faxing are legible. Failure to provide legible documents will delay your renewal.
Print Name: _______________________________________
Print Complete Professional License No. : _____________________ if renewing your license.
(Examples: RN123456 or UCAR12345)
If applying for a new license, print type of license you are applying for here: ________________________
Use Fax No. 1-866-888-9718 for the following:
Use Fax No. 1-866-888-1308 for the following:
Architects/Interior Designers
Athletic Trainers
Engineers & Land Surveyors
Chiropractic Examiners
Foresters
Massage Therapists
Geologists
Occupational Therapists
Landscape Architects
Physical Therapists
Podiatry
Veterinary Medicine
Use Fax No. 1-866-888-1176 for the following:
Barbers & Cosmetology
Libriarians
Use Fax No. 1-866-888-7127 for the following:
Use Fax No. 1-866-888-8026 for the following:
Dietitians
Dispensing Opticians
Athletic Agents
Hearing Aid Dealers & Dispensers
Auctioneers
Nursing Home Administrators
Cemeteries
Optometry
Funeral Director & Embalmers
Professional Counselors/Social Workers/
Private Detectives/Security Guards
Marriage and Family Therapists Psychologists
Used Motor Vehicle Dealers
Speech Language Pathologists & Audiologists
Used Motor Vehicle Parts Dealers
Water/Wastewater Treatment Plant Operators
Use Fax No. 1-877-371-5712 for the following:
Use Fax No. 478-207-1458 for the following:
Nursing (RN/LPN)
Conditioned Air Contractors
Music Therapy
Electrical Contractors
Low Voltage Contractors
Plumbing Contractors
Residential/General Contractors
Utility Contractors

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