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Board of Examiners in Physical Therapy - Applications & Forms

Applications for Examinations

• Application for Eligibility to Qualify for the Physical Therapist Assistant (PTA) Examination
• Application for Eligibility to Qualify for the Physical Therapist (PT) Examination
• Application to Retake the PTA or PT Examination

The above applications are solely for determining a persons eligibility to qualify for for an exam. It does not qualify an applicant for licensure at this time.

Once an exam candidate has passed an exam, they would be required to submit a separate application for licensure.

Applications for Licensure

• Application for License for Physical Therapist Assistant (PTA) - once you have taken and passed the PTA examination
• Application for Licensure for Physical Therapist(PT) - once you have taken and passed the PT examination
• Application by Endorsement for PTA or PT License
• Application for Reinstatement of PTA or PT - 91 days to 2 years

 

Forms

• Verification of Licensure Request Form
• Replacement License Request Form
• ADA Accomodation Request Form
• Reference Form
• Supervisor's Affidavit Form
• Credit Card Authorization Form
  To authorize payment of fees by Visa or MasterCard.

 

If you cannot find what you are looking for, click HERE to send an e-mail message to the Physical Therapy Board.

 

Last Updated: April 25, 2013

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Examinations

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contact us

• Board of Physical Therapy
• 35 State House Station
• Augusta, ME 04333-0035
• Phone: (207) 624-8689
• Fax: (207) 624-8637
• TTY users call Maine relay 711
• Program Staff

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