Home Inside the Board Current Info CE Info PT/PTA Contact Us FAQ LINKS FORMS Forms The Board of Physical Therapy makes available a number of forms for download by the public. Some forms may require a processing fee in order to download. All forms are listed below and will indicate the required processing fee, if any. Foreign-educated applicants must follow the steps as listed on this Site under PT/PTA; then "Foreign-educated PT Applicants ONLY". The Instructions and Application available here are not the Forms that Foreign-educated applicants should use. Changes in address or work information may be submitted by completing the Form on this Site and mailing, faxing or emailing. 1. Instructions for Endorsement Applicants For Physical Therapists and Physical Therapist Assistants applying for licensure by endorsement from another state. Download Fee: FREE Download Now 2. PT / PTA Application Application to become a licensed Physical Therapist or Physical Therapist Assistant in West Virginia Download Fee: FREE Download Now 3. Instructions for Exam Applicants For Physical Therapist and Physical Therapist Assistant Exam Candidates Download Fee: FREE Download Now 3a. Exam Applicant Checklist (wpd format) Checklist of what forms to download and what to submit for licensure, exam, and temporary permit. Download Fee: FREE Download Now 3b. Exam Applicant Checklist (doc format) Checklist of what forms to download and what to submit for licensure, exam, and temporary permit. Download Fee: FREE Download Now 3c. Exam Applicant - Special Accommodations Request Form Please complete this form if you have any needs for special accomodations for the exam. Download Fee: FREE Download Now 3d. Exam Instructions and Registration You may apply for the examination only while you are applying for a WV License. Download Fee: FREE Download Now 4. Temporary Application A position as a PT / PTA in WV is required before requesting a Temporary License Permit. Download Fee: FREE Download Now 5. Name / Address Change Notification Form You are required to provide the board with current contact information. Download Fee: FREE Download Now 6. Affidavit of Lost or Replacement Documents Print and complete this form to request replacement documents from the board. Download Fee: FREE Download Now 7. 2010 PT Biennial Renewal or Inactive Status Application 2010 PT Application for Biennial Renewal or Inactive Status. Please complete this form, if you wish to mail your 2010 renewal form. You do not need this form if you are renewing online. Download Fee: FREE Download Now 8. 2010 PTA Biennial Renewal or Inactive Status Application PTA 2010 Application for Biennial Renewal or Inactive Status. Please complete this form, if you wish to mail your 2010 renewal form. You do not need this form if you are renewing online. Download Fee: FREE Download Now NOTE: If you have previously submitted an order for forms, you may LOG IN to view your orders. If you are a WV PT or PTA with an Inactive or Lapsed License and wish to Re-Activate, please contact the Board Office in order to receive the correct Form to complete. You may contact the Office via email: wvbopt@wv.gov or by fax: (304) 304-558-0369 for your convenience.
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