State Physical Therapy & Occupational Therapy Board

Applications & Forms

NEW License Applications

• Physical Therapist and Physical Therapy Assistant Application
  #08-4065, Revised 03/13/2020
• Occupational Therapist and Occupational Therapy Assistant Application
  #08-4123, Revised 03/13/2020
• Physical Therapy and Occupational Therapy Limited Permit Application
  #08-4578, Revised 04/04/2019
• Foreign-Trained Physical Therapist and Physical Therapy Assistant Application
  #08-4091, Revised 09/29/2019

RENEWAL License Applications

• Biennial Physical Therapist and Physical Therapy Assistant License Renewal Application
  #08-4116, Revised 04/26/2022
• Biennial Occupational Therapist and Occupational Therapy Assistant License Renewal Application
  #08-4114, Revised 04/26/2022

REINSTATEMENT License Applications

• Physical Therapist and Physical Therapy Assistant Reinstatement Application
  #08-4388, Revised 09/05/2014
• Occupational Therapist and Occupational Therapy Assistant Reinstatement Application
  #08-4570, Revised 09/05/2014

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