Department of Professional and Occupational Regulation (DPOR), Commonwealth of Virginia fax number

Fax destination details

Department

Name Change Processing (A406) within DPOR

Purpose

Submitting DPOR Name Change Form A406 (A406-NAMECHG) to update professional licenses/registrations

Form

A406-NAMECHG — Name Change Form

Address

9960 Mayland Drive, Suite 400, Richmond, VA 23233-1485

Voice phone

(804) 367-8500

Website

Visit organization website

Before you send

• Confirm that this exact department handles your document or request.
• Check the organization website or call its main line for the current fax number.
• Include a cover sheet and any case, member, claim, or form reference required.
• Keep the delivery confirmation with your submission records.

Fill out DPOR Name Change Form A406-NAMECHG: indicate whether the change is Individual or Business; list each license/certification/registration with current name and the new name (for Business, current DBA and new name). Include copies of supporting documentation (e.g., marriage certificate, divorce decree, court order). Provide contact numbers and emails; sign and date. Submit by mail to DPOR or fax to the number provided (866-266-6818).

Official form instructions are published as a downloadable file on the organization's website.