Out of State Genetic Counselor License Applicants
Initial Out of State Application
1. Complete Genetic Counselor License application CDPH 4486, pages 1-3, signature on page 3 must be in blue ink.
If applicable, include official documentation pertaining to questions 1-11.
2. Complete Genetic Counselor License Payment form CDPH 4487, and attach money order or complete VISA/MasterCard information.
3. Provide a 2" X 2" Passport size photo (head and shoulders only) taken within 60 days of filing this application.
4. When applying for a Genetic Counselor License, submit a copy of current certification from American Board of Genetic Counseling (ABGC) or American Board of Medical Genetics (ABMG).
Licensure requires that applicants be in "Good Standing" with ABGC (maintaining certification requirements). You can verify your current status by emailing info@ABGC.net.
Fingerprint Card Information
1. You will have to request a fingerprint card from our department by filling out form CDPH 4490, California Genetic Counselor Fingerprint Card Request form.
2. We will send a fingerprint card along with instruction on how to fill the card out correctly; and you will go to your local police department to have your fingerprints manually rolled.
"If you are having difficulty accessing this document please contact CDPH at (510) 412-6209 or at PSQAGroup@cdph.ca.gov to request this information in an alternate format."