The application is active for one year from the date of submission after which it will be destroyed if it has not been completed, including the furnishing of all documents and records that are requested. File to be destroyed per the state functional record retention schedule.
ATTENTION: If you printer is not graphics capable, the forms may be missing vital information. If there are any parts of the application that are blacked out and/or not readable, please contact our office (919) 490-6393 or (800) 800-8982 to receive a hard copy of the application.
For Physical Therapist
For Physical Therapist Assistants
Military Trained Technician PTA Licensure
Instructions for applying by endorsement from another state
Download PT & PTA Endorsement Applications
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