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Our office cannot accept personal checks over $25.00 nor any cash.
Fees may be paid via cashier's check, business check, or money order.

All forms and applications shall be completed in its entirety to be accepted.

1. Endorsement Applicant Checklist and Licensure Application
For licensed Physical Therapists and Physical Therapist Assistants applying via endorsement from another state.
Download Fee: FREE
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1a. Verification Request for Endorsement Applicants
Please complete this form and forward to any jurisdictions you are or have ever been licensed (active or not) as a PT/PTA.
Download Fee: FREE
Download Now

2. Foreign Applicant Checklist and Licensure Application
For PT applicants not educated in the United States.
Download Fee: FREE
Download Now

3. Exam Applicant Checklist and Licensure Application
For individuals applying to become a licensed Physical Therapist or Physical Therapist Assistant via NPTE.
Download Fee: FREE
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3a. Exam Application
You must submit this form with your licensure application and again for each additional exam.
Download Fee: FREE
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3b. Exam Special Accommodations Request Form
You may submit this form with your licensure and exam applications if you require special accommodations for the exam.
Download Fee: FREE
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3c. Temporary Permit Application
You may submit this form with your licensure and exam applications. A conferred PT/PTA degree and a position as a PT/PTA in WV are required.
Download Fee: FREE
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3d. PT/PTA Licensure Application
Licensure applications expire one year from your signature date. If yours has expired, you must submit a new licensure application and $25.00 fee.
Download Fee: FREE
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4. CE Requirements for Reactivation
Please refer to these CE requirements for reactivation of a delinquent or inactive license.
Download Fee: FREE
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4a. Reactivation of a Delinquent License Application and Instructions
For licensees wishing to reactivate a delinquent license.
Download Fee: FREE
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4b. PT Reactivation of an Inactive License Application and Instructions
For Physical Therapists wishing to reactivate an inactive license.
Download Fee: FREE
Download Now

4c. PTA Reactivation of an Inactive License Application and Instructions
For Physical Therapist Assistants wishing to reactivate an inactive license.
Download Fee: FREE
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4d. PT Inactive Application
For Physical Therapists requesting inactive status.
Download Fee: FREE
Download Now

4e. PTA Inactive Application
For Physical Therapist Assistants requesting inactive status.
Download Fee: FREE
Download Now

6. Affidavit of Lost or Replacement Documents
Submit this form to request replacement documents from the board.
Download Fee: FREE
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7. Name / Address Change Notification Form
You are required to provide the board with current contact information.
Download Fee: FREE
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8. Emergency & Temporary Absence Form
You are required to complete this form for any emergency or temporary absences. This form must be turned in with your biennial renewal.
Download Fee: FREE
Download Now

9. Request for Waiver of Continuing Education
Submit this form if you need to request a waiver of continuing education.
Download Fee: FREE
Download Now

Certification of Copy
Use this form for a Notary to verify a copy as an original.
Download Fee: FREE
Download Now

WV Verification Request Form
Complete and submit this form to our office if you need verification of your WV license/registration sent to another jurisdiction.
Download Fee: FREE
Download Now



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West Virginia Board of Physical Therapy
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