Online Forms

• Address Change
• Annual Renewal
• Course Provider Approval Request
• Duplicate License Request
• Mailing List Request
• Statement of Complaint
• Written Verification of License

Printable Forms

• ADA Accommodation Request
• Address Change
• Clinical Instructor CE Form
• Application for Licensure -- PT or PTA
• Atendee Course Prior Approval Application
• Certificate of Dean/Register -- Physical Therapist
• Certificate of Dean/Register -- Physical Therapist Assistant
• Course Provider Approval Request
• Duplicate License Request
• Evaluation Skills Checklist
• Examination Information
• Legal Name Change
• Mailing List Request
• PT Provisional Supervisory Request
• PTA Provisional Supervisory Request
• Statement of Complaint
• Written Verification of License

For any other types of requests please send an email including a detailed description of your request to lsbpte@laptboard.org. Please be sure to include your full name, address, and phone number in all email correspondence.