Forms

The following forms are available for download using the Adobe Reader: Accommodation Request Form Affidavit of License Application for Licensure By Endorsement - PT or PTA Application for Licensure By Examination - PT or PTA Certification of Current License in Another State Certification of Physical Therapy Education Character Reference Data Update Form Fee Schedule Information For Complainants Memorandum of Complaint Petition for Adoption of Rule PT and PTA Application Form Release of Application Information to the Applicant Supervisory Agreement for Temporary Licensure Memorandum Supervisory Agreement for Temporary Licensure Form Instructions for Registering Online National Physical Therapy Examinations 2012 License Renewal