Probation Forms
Quarterly DeclarationPenalty Relief
Business and Professions Code Sections 2221(b) and 2307 allow an individual whose license has been surrendered, revoked or suspended to petition the Medical Board of California for reinstatement of the license or modification of the penalty. Section 2307 also authorizes an individual whose license is on probation, due to either a disciplinary action taken by the Board or because the license was issued on probationary status, to petition the Board to modify or terminate previously imposed terms and conditions or to request that the Board terminate the probation early.
Timeframes for Filing
Petition for Reinstatement — A person may file a Petition for Reinstatement after a period of at least five (5) years has elapsed from the effective date of the surrender or revocation. If the reinstatement is due to a license surrender or revocation for mental or physical illness, a person may file a Petition for Reinstatement after one (1) year has elapsed from the effective date of the disciplinary order.
Petition for Early Termination of Probation — A person may file a Petition for Early Termination of Probation after serving at least two (2) years of their probation term or more than one-half (1/2) of their probation term, whichever is greater. For all disciplinary orders, if the ordered period of probation is less than three (3) years, a person may file a Petition for Early Termination of Probation after one (1) year has elapsed from the effective date of the disciplinary order.
Petition for Modification — A person may file a Petition for Modification when at least one year has elapsed from the effective date of the disciplinary action or the date the license was issued in probationary status.
Fees for Petitions for Penalty Relief
For a disciplinary decision ordered on or after April 2, 2026, the petition for penalty relief must be submitted on the form labeled Petition for Penalty Relief — Fee Required.
Carefully review and follow the instructions on the form. Among other requirements, the petitioner must include:
- a non-refundable initial fee of $2,962 for a Petition for Reinstatement; or
- a non-refundable initial fee of $1,242 for a Petition to Terminate Probation and/or a Petition to Modify Probation.
NOTE: The remaining fee of up to $22,000, less the initial fee, to cover the reasonable costs to process and adjudicate the petition shall be proposed by an administrative law judge and approved by the Board.
For more information pertaining to fees for petitions for penalty relief, please see 16 CCR section 1352.3 and 16 CCR section 1359.
- Live Scan Form
- Live Scan Locations
- Petition for Penalty Relief — Fill-In (For decisions ordered before April 2, 2026)
- Petition for Penalty Relief — Fee Required — Fill-In (For decisions ordered on or after April 2, 2026)