Application Forms & Publications

ONE YEAR (1) ABANDONMENT OF APPLICATIONS

Pursuant to HAR §16-110-10(d) Your application shall be considered abandoned, will be destroyed, if you fail to complete the license process within one year after filing the application, or fail to take and pass the examination after becoming eligible to take the examination. If an application is deemed abandoned the applicant shall be required to reapply for licensure and comply with the licensing requirements at the time of the reapplication.

Physical Therapist License

Abandoned Application Important Notice and FAQ’s

Information, Requirements, Instructions & Application
Application Fillable Form

Verification of License
Application Fillable Form

Statement of Supervising Licensed Physical Therapist
Application Form

Physical Therapist Assistant License

Abandoned Application Important Notice and FAQ’s

Information, Requirements, Instructions & Application
Application Fillable Form

Experience Verification for Exam Waiver
Application Fillable Form

Inactivation Application for Physical Therapist & Physical Therapist Assistant

Instructions & Application
Application Fillable Form

Reactivation Application for Physical Therapist & Physical Therapist Assistant

Instructions & Application
Application Fillable Form