License Applications

Physical Therapist and Physical Therapy Assistant Application, #08-4065, Revised 04/06/11.

Occupational Therapist and Occupational Therapy Assistant Application, #08-4123, Revised 04/06/11.

Physical Therapy and Occupational Therapy Limited Permit Application, #08-4578, Revised 04/06/11.

Foreign-Trained Physical Therapist and Physical Therapy Assistant Application, #08-4091, Revised 08/11/10

Renewal and Reinstatement Applications

Biennial Physical Therapist and Physical Therapy Assistant License Renewal Application, #08-4116, Revised 04/21/10.

Biennial Occupational Therapist and Occupational Therapy Assistant License Renewal Application, #08-4114, Revised 04/21/10.

Physical Therapist and Physical Therapy Assistant Reinstatement Application, #08-4388, Revised 04/06/11.

Occupational Therapist and Occupational Therapy Assistant Reinstatement Application, #08-4570, Revised 04/06/11.

Miscellaneous Forms

Request for License Verification, #08-4222, Revised 11/28/07

Request for Duplicate Professional License, #08-0014,
Revised 06/11/07

Change of Name Form, #08-1431, Revised 04/20/09

Change of Address Form, #08-4291, Revised 04/20/09

Credit Card Payment Form, #08-4438, Revised 03/03/09