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Board of Examiners in Physical Therapy - Applications & Forms

 

Applications

• Application form License by Endorsement
• Application form License by Examination
• Application for Reinstatement of License
• Application form Retake Examination

 

Forms

• Verification of Licensure Request Form
• Replacement License Request Form
• Notice to all applicants regarding HIPDB reports **
• Credit Card Authorization Form
  To authorize payment of fees by Visa or MasterCard.

** What is a NPDB/HIPDB Self Query?

 

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

 

 

Last Updated: April 24, 2009

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• Board of Physical Therapy
• 35 State House Station
• Augusta, ME 04333-0035
• Phone: (207) 624-8689
• Fax: (207) 624-8637
• TTY: (888) 577-6690
• Program Staff

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