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Below is a list of multiple instructions, applications and forms.

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

The board does not accept cash nor personal checks. All fees must be paid in the form of a money order, business check or cashiers check.

1. Endorsement Checklist and Application for Licensure
For Physical Therapists and Physical Therapist Assistants applying for licensure by endorsement from another state.
Download Fee: FREE
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1a. Foreign Applicants
PT application and instructions for applicants not educated in the United States.
Download Fee: FREE
Download Now

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.
Download Fee: FREE
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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.
Download Fee: FREE
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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.
Download Fee: FREE
Download Now

3b. Exam Applicant-Special Accommodations Request Form
Please complete this form if you have any needs for special accommodations for the exam.
Download Fee: FREE
Download Now

4. CE Requirements for Reactivating Licensee
Please refer to these CE requirements for reactivation of a delinquent or inactive license.
Download Fee: FREE
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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.
Download Fee: FREE
Download Now

4a1. PT Application for Reactivating an Inactive License Instructions
PT Inactive licensee's need to read these instructions and complete the application for reactivation.
Download Fee: FREE
Download Now

4b. PTA Application for Reactivating an Inactive License Instructions
PTA Inactive licensee's need to read these instructions and complete the application for reactivation
Download Fee: FREE
Download Now

4c. PT Inactive Application
PT Inactive Application for current WV licensees that wish to place their license in "Inactive" status.
Download Fee: FREE
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4d. PTA Inactive Application
PTA Inactive Application for current WV licensees that wish to place their license in "Inactive" status.
Download Fee: FREE
Download Now

5. Temporary Application
A position as a PT/PTA in WV is required before requesting a temporary licensure permit. You must also complete a PT/PTA licensure application and pay licensure and application fees before you can be issued a temporary licensure permit.
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. Name / Address Change Notification Form
You are required to provide the board with current contact information.
Download Fee: FREE
Download Now

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
Complete this form if you need to request a waiver of continuing education.
Download Fee: FREE
Download Now

9a. Certification of Copy
Use this form for a Notary to verify a copy as an original.
Download Fee: FREE
Download Now

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.
Download Fee: FREE
Download Now

WV Verification Request Form
Complete this form if you need a WV Verification sent to another jurisdiction.
Download Fee: FREE
Download Now



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