Anesthesiologist Assistant

Pursuant to 2017 Wisconsin Act 278, beginning August 1, 2018, prior to submitting an application for a credential, an individual may apply to the Department for a determination of whether the individual would be disqualified from obtaining the credential due to his or her conviction record. To apply for a predetermination, please fill out Form 3085 and submit all required documentation specified on the form. Pursuant to Wis. Stat. § 111.335(4)(e), the offenses or kinds of offenses that may result in a refusal, bar, or termination of licensure are published under Additional Resources on the left side of this page.

License Information

Fee Reduction

Pursuant to 2017 Wisconsin Act 319, beginning August 1, 2018, an applicant for an initial credential may apply for a reduction of the initial credential fee that is equal to 10% of the initial fee. Qualification is based on the federal adjusted gross income being at or below 180% of the federal poverty guideline prescribed for the applicant's family household size by the United States Department of Health and Human Services. To determine eligibility please visit the United States Department of Health and Human Services website prior to submitting Form 3217.

Per Wis. Stat. §​ 440.08(2), the required renewal date for the Anesthesiologist Assistant credential is 09/30/even years.  Should you receive your initial credential in the months leading up to this date, you are still required to renew your license by the statutorily defined date.

Licensure is required for any person who practices as an anesthesiologist assistant, who holds themselves out as one authorized to practice as an anesthesiologist assistant or who uses the letters “A.A.” or any other designation that tends to represent the person as an anesthesiologist assistant.

Temporary Licensure

Temporary licenses are available to applicants who are eligible to take, but have not passed the national exam. The Board may grant a temporary license once the application for licensure Form​ 2976, request for temporary license Form 2979 and fees are received by the Department.

A temporary license expires on the date on which the board grants or denies an applicant permanent licensure or on the date of the next regularly scheduled examination required under Wis. Stat. § 448.05(6) if the applicant is required to take, but has failed to apply for, the examination.

Pre-Credential Education Information

A bachelor’s degree and satisfactory completion of an anesthesiologist assistant program that is accredited by the Commission on Accreditation of Allied Health Education Programs (or by a predecessor or successor entity).

Application for Licensure

2976Application For Licensure as an Anesthesiologist Assistant
​Application for Fee Reduction (If applying for a fee reduction, this form must accompany Form #2976.)
2977Anesthesiologist Assistant Certificate of Professional Education
2975Request for National Examination Scores
​2979Request for Temporary License for Anesthesiologist Assistant
2829Malpractice Suits or Claims Form (if applicable)
3085​Application for Predetermination (Submit ONLY if you have been convicted of any felony, misdemeanor, or other violations of federal, state, or local law, including municipal ordinances, in this state or any other)
2252​Convictions and Pending Charges
3071Fax Payment Form

Renewal Information


  • FEE (See Renewal Dates and Fees)
  • NTL (Current certification by the National Commission on Certification of Anesthesiologist Assistants)
  • If your legal status as a qualified alien or nonimmigrant lawfully present in the United States has changed since the issuance of your credential or your last renewal, please contact the Wisconsin Department of Safety and Professional Services at (608) 266-2112 or

Renewal Methods

RDAFRenewal Dates and Fees
R210Active Duty/Discharge Renewal Extension

Wisconsin Act 210 (effective June 1, 2012)

This Act extends the license of a service member if the license expires while they are on active duty from 90 days to 180 days from the date of discharge. The same applies to a spouse of a service member if the spouse does not practice under their license while the service member is on active duty and does not practice because the service member is on active duty.

This Act repeals a provision of prior law that required a service member to meet all of the requirements for license extension or renewal, except for continuing education requirements, in order to have the license extended.

Service members and spouses may request extensions of licenses beyond 180 days from discharge and may request a waiver or extension of time to complete continuing education requirements due to hardship. Please view Active Duty/Discharg​e Renewal Extension Form R2​10 for further information.