1. Endorsement Checklist and Application for Licensure
For Physical Therapists and Physical Therapist Assistants applying for licensure by endorsement from another state.
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2. PT / PTA Application
Application to become a licensed Physical Therapist or Physical Therapist Assistant in West Virginia. This application is for Exam, Endorsement, and WV delinquent/inactive licensee applicants.
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3. New Grad /Exam Application Checklist & Application for Licensure
Exam Checklist and Application. Includes a list of forms to download and what to submit for licensure, exam, and temporary permit.
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3a. Exam Application Instructions and Exam Application
You may apply for the examination only while you are applying for a WV License. Attached are exam application instructions and exam application.
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3b. Exam Applicant-Special Accommodations Request Form
Please complete this form if you have any needs for special accommodations for the exam.
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4. CE Requirements for Reactivating Licensee
Please refer to these CE requirements for reactivation of a delinquent or inactive license.
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4a. Application for Reactivating a Delinquent License Instructions
Delinquent licensee's need to read these instructions and complete the application for reactivation.
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4a1. PT Application for Reactivating an Inactive License Instructions
PT Inactive licensee's need to read these instructions and complete the application for reactivation.
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4b. PTA Application for Reactivating an Inactive License Instructions
PTA Inactive licensee's need to read these instructions and complete the application for reactivation
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4c. PT Inactive Application
PT Inactive Application for current WV licensees that wish to place their license in "Inactive" status.
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4d. PTA Inactive Application
PTA Inactive Application for current WV licensees that wish to place their license in "Inactive" status.
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5. Temporary Application
A position as a PT/PTA in WV is required before requesting a Temporary License Permit.
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6. Affidavit of Lost or Replacement Documents
Print and complete this form to request replacement documents from the board.
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7. Name / Address Change Notification Form
You are required to provide the board with current contact information.
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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.
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9. Request for Waiver of Continuing Education
Complete this form if you need to request a waiver of continuing education.
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9a. Certification of Copy
Use this form for a Notary to verify a copy as an original.
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Verification Request for Endorsement Applicants
Please complete this form and forward to all jurisidictions that you have currently have or ever held a license or registration.
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WV Verification Request Form
Complete this form if you need a WV Verification sent to another jurisdiction.
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