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State Physical Therapy and Occupational Therapy  Board
State of Alaska >Commerce >Professional Licensing > Physical & Occupational Therapy
 
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License Applications:

Physical Therapist and Physical Therapy Assistant Application,
#08-4065, Revised 05/16/08 Includes application for non-resident 120 day limited permit.

Occupational Therapist and Occupational Therapy Assistant Application, #08-4123, Revised 05/16/08. Includes application for non-resident 120 day limited permit.

Foreign-Trained Physical Therapist and Physical Therapy Assistant Application, #08-4091, Revised 05/16/08

Renewal and Reinstatement Applications:

Physical Therapist and Physical Therapy Assistant Renewal Application, #08-4116, Revised 04/28/08

Occupational Therapist and Occupational Therapy Assistant Renewal Application, #08-4114, Revised 04/28/08

Reinstatement Application, #08-4388, Revised 04/07/08. Reinstatement for Physical Therapist, Physical Therapy Assistant, Occupational Therapist, Occupational Therapy Assistant for licenses lapsed more than two years.

 

 

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Applications may be viewed and printed with Adobe Acrobat Reader 6.0 or higher. If you do not have Adobe Acrobat Reader 6.0 or higher, please click on the Adobe logo and download the free software now. If you are unable to view or download an application, please contact us by telephone or e-mail. Providing your complete mailing address will enable us to mail you the application.

Other application forms may be mailed to you or picked up at a division office. Completed applications must be signed and submitted to the division with the appropriate fees.

 
 

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