State Physical Therapy & Occupational Therapy Board

Appications & Forms

NEW License Applications

• Physical Therapist and Physical Therapy Assistant Application
  #08-4065, Revised 3/13/2020
• Occupational Therapist and Occupational Therapy Assistant Application
  #08-4123, Revised 3/13/2020
• Physical Therapy and Occupational Therapy Limited Permit Application
  #08-4578, Revised 4/04/19
• Foreign-Trained Physical Therapist and Physical Therapy Assistant Application
  #08-4091, Revised 9/29/19

RENEWAL License Applications

• Biennial Physical Therapist and Physical Therapy Assistant License Renewal Application
  #08-4116, Revised 5/11/2020
• Biennial Occupational Therapist and Occupational Therapy Assistant License Renewal Application
  #08-4114, Revised 5/11/2020

REINSTATEMENT License Applications

• Physical Therapist and Physical Therapy Assistant Reinstatement Application
  #08-4388, Revised 9/05/14
• Occupational Therapist and Occupational Therapy Assistant Reinstatement Application
  #08-4570, Revised 9/05/14

Miscellaneous Forms may be located under CBPL QUICK Links in the sidebar.