Application, Forms and Instructions
The following forms are in PDF format. You will need Adobe Acrobat Reader to view, download, or print.
For those individuals wishing to become credentialed in Kentucky as a Physical Therapist or Physical Therapist Assistant, please print the instructions, application form, HIV/AIDS Instructions, and other necessary forms. You may also call or email the office to have an application package mailed to you.
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Renewal/Reinstatement |
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To renew or reinstate your Kentucky license/certificate:
Instructions for Renewal (PDF-126KB)
Instructions for Reinstatement (PDF-121KB)
Renewal & Reinstatement Application (PDF-102KB)
HIV/AIDS Requirement - 2 hours (PDF-100KB) Not required for this renewal cycle.
Verification Form (PDF-108KB) This form is to request verfication of your PT/PTA credential from another state licensing board to be sent to the KY Board of Physical Therapy.
Other State Boards Address and telephone numbers of other physical therapy licensing jurisdictions.
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Examination Candidates |
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For candidates who are applying for their Kentucky PT/PTA credential by examination:
Instructions (PDF-36K)
To Do List - PT Exam Candidate (PDF-35K)
To Do List - PTA Exam Candidate (PDF-35K)
Application (PDF-94K)
ADA REQUEST FORM (PDF-122KB)
HIV/AIDS Instructions (PDF-97KB) Course requirement has changed to two (2) hours
www.fsbpt.org Online exam registration with the FSBPT 
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Endorsement Candidates |
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For candidates who are already licensed/certified in another licensing jurisdiction:
Instructions (PDF-159KB)
Application (PDF-94KB)
HIV/AIDS Instructions (PDF-97KB)
www.fsbpt.org FSBPT Score Transfer
Verification Form (PDF-108KB) This form is to request verfication of your PT/PTA credential from another state licensing board to be sent to the KY Board of Physical Therapy.
Other State Boards Address and telephone numbers of other state PT Boards.
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Foreign Educated Applicants |
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Foreign Educated Exam Instuctions (PDF-141KB)
To Do List (exam candidates only)
Foreign Educated Endorsement Instructions (PDF-116KB)
Application (PDF-94KB)
HIV/AIDS Instructions (PDF-97KB)
Foreign Educated Supervisory Form
Verification Form (PDF-69KB)
www.fsbpt.org Online exam registration with the FSBPT
KRS 327.060 Statute for Licensing Requirements for Foreign Educated
201 KAR 22:070 Regulation for Foreign Educated
Information on Foreign Credentialing Agencies accepted by the KY Board can be found under Resources.
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Other Forms & Information |
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Change Notification Form (PDF-124KB)
For a name change, mail or fax a copy of the legal document authorizing the change to the board office. Your records will be changed in-house.
Wallet Cards - $10.00
Wall Certificates $20.00
Other State Boards Address and telephone numbers of other physical therapy licensing jurisdictions.
Verification Request (PDF-16KB) Do you need to verify your KY PT/PTA credential to another agency? Please submit a signed request to the board office along with the fee of $15 for each verification.
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Questions or Clarification |
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If you have questions regarding any of the above or need clarification, please feel free to email the board office at KYBPT@ky.gov or call the office at (502) 429-7140.
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